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Location

Arizona City, AZ | United States

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Job description

Quadris Team, LLC - A Revenue Cycle Management Group, is searching for that dynamic person to join us, working with our highly skilled and growing Medical Coding Team to fill the role of Lead Medical Coding Profee Specialist. We are a 100% remote team supporting our clients across the United States! See us at

Job Focus : This role is responsible for conducting new client implementation, training, client specific job aids, Quadris job aids, coding audits and provides educational programs based on auditing results, and production coding when needed. Effectively uses abstracting databases, internal and external audit results, QIO reports and revenue cycle edit/denial information. Effectively interacts with both coding staff and different levels of management within Quadris and with our client leadership teams. This individual must demonstrate a commitment to the organization's strategic plans, short- and long-term goals and mission, vision, and values by representing the company in a caring and professional manner.

Primary/Essential Expectations for Success:

• Audits to verify coding and grouping accuracy as needed
• Performs educational sessions for coding specialists, client leadership teams and physicians when requested
• Reports on coding and grouping accuracy based on audit results
• Serves as an expert resource for all coding staff
• Utilizes technical coding expertise to review the medical record thoroughly, utilizing all available documentation to abstract and code facility and physician professional services and diagnosis codes (inpatient admissions, surgical procedures, and/or diagnostic services)
• Follows Official Coding Guidelines and rules to assign appropriate CPT, ICD10 codes and modifiers with a minimum of 95% accuracy
• Provides documentation feedback to client and or account manager.
• Maintains coding reference information
• Reviews and communicates new or revised billing and coding guidelines and information with providers and their assigned specialty
• Resolves pre-accounts receivable edits. Identifies and reports repetitive documentation problems as well as system issues
• Makes appropriate changes to incorrectly billed services, adds missing unbilled services, provides missing data as appropriate, corrects CPT and ICD-10 codes and modifiers
• May collaborate with Patient Accounting, and other operational areas to provide coding reimbursement assistance; helps identify and resolve incorrect claim issues and may assist with drafting letters to coordinate appeals
• May work with Revenue Cycle staff and Account Inquiry Unit staff as requested, assists in obtaining documentation (notes, operative reports, etc.). Provides additional code and modifier information
• Meets established minimum coding productivity and quality standards for each encounter type based on type of service coded
• May perform other duties as assigned
• Reads bulletins, newsletters, and periodicals and attends workshops to stay abreast of issues, trends, and changes in laws and regulations governing medical record coding and documentation.
• Identifies training needs, prepares training materials, and conducts training for physicians and support staff to improve skills in the collection and coding of quality health data.
• Makes recommendations for changes in policies and procedures; works with data processing staff to revise the computer master file. Develops and updates procedures manuals to maintain standards for correct coding, to minimize the risk of fraud and abuse, and to optimize revenue recovery.
• Evaluates records and prepares reports on such topics as the number of denied claims or documentation or coding issues for review by management and/or professional evaluation committees.

Primary Focused Work: (This is not an exhaustive list)

• New client implementation
  • Testing software
  • Client specific job aids
  • Training on client expectations
  • Provides ongoing monitoring for client success
• Internal Coder account review for AR specialists
• Coding education for AR specialists
• Reviews and processes requests for mailing claims and documents

Skills Needed to Be Successful:

• Ability to accurately sequence principle diagnosis and procedures, complications and comorbid conditions on inpatient and outpatient accounts
• Ability to provide guidance to other departmental staff in identifying and resolving coding issues or errors
• Ability to analyze and resolve claim denials that are rejected by edits from the Patient Accounts department
• Ability to maintain the national standards for coding accuracy and internal standards for productivity
• Maintainscompliancewithregulationsandlawsapplicable tojob
• Professional level of communication with video, phone, and email
• Ability to effectively prioritize the work to meet deadlines and expectations
• Meets the quality and productivity measures as outlined by Quadris
• Brings positive energy to work
• Uses critical thinking skills
• Problem solving independently
• Being present and focused on assigned tasks and eliminates distractions
• Being a self-starter
• Ability to work independently and within a team atmosphere

Core Talent Essentials:

• High School diploma or equivalent
• Required AHIMA or AAPC Certification
• 5+ years of experience in healthcare medical coding; IP, OP, Pro Fee experience preferred
• Ability to work independently and within a team atmosphere
• Advanced and proficient knowledge of CPT and ICD-10
• Self-motivated and passionate about our mission and values of quality work
• Must have professional level skills in MS products such as Excel, Word, Power Point.
• Must be able to type proficiently and with an effective pace
• Proficient application of business/office standard processes and technical applications

Physical Environment:

• Prolonged periods of sitting at a desk and working on a computer
• Must be able to lift 15 pounds at one time
• Must be able to structure your home office to ensure patient information is secure meeting the regulatory expectations

Quadris is an Equal Employment Opportunity employer. Any offer of employment is contingent upon a criminal background check, previous employment verification and references, following all federal and state regulations. Quadris Team is a participant of eVerify.

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