The Medical Coding QA Specialist (CPC Certified) is responsible for the quality assurance of our internal coding team and performs quality audits to ensure compliance with coding guidelines, as well as departmental policies and procedures. This position holds additional duties with respect to research, and participation in root cause analysis and identifying process improvements and communicating results to provide performance feedback and continuous refinement. This would be a 100% REMOTE position. 

Responsibilities:

· Leverages extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing to audit coded charts.

· Provide coding, financial and/or operational reports, and provide feedback to improve documentation to maximize revenue and reduce denials.

· Performs audits of the coding team, providing feedback and education based on results.

· Develops overall educational materials based on common trends identified during the audit process.

· Conducts internal coding audits and analysis of issues holding up accounts and follows guidelines.

· Identifies areas of utilization improvements and monitors expected outcomes.

· Identifies recurring problems and procedural deficiencies and provides solutions to eliminate them.

· Research and update new and/or revised coding and compliance standards.

· Reviews, monitors, and tracks work queues in Epic and provide support as needed.

· Performs other related duties as required or requested.

Qualifications:

· High school diploma or equivalency

· Epic is a MUST HAVE!

· AAPC Certified Professional Coder (CPC) certification is a MUST HAVE!

· Other relevant certifications (e.g., CRC, CPB) are a plus.

· Maintain departmental productivity levels and compliance with quality standards.

· A minimum of 5 years of experience in a multi-specialty physician practice or clinic, coding multiple medical/surgical specialties/subspecialties.

· A minimum of 1 year of prior experience translating coding error trending and quality assurance and translating these results into process improvements with minimum supervision required.

· Advanced knowledge of ICD10, CPT and HCPCS coding guidelines, payer, and governmental policies.

· Proficiency in using medical billing software and EHR systems, Epic.

· Attention to detail with the ability to identify/resolve problems and document the outcome.

· Ability to collaborate effectively in a team setting to maximize quality and efficiently of operations.