Supports our coding QA process and coder and provider documentation integrity and education.
Provides clinical documentation review to support correct coding and regulatory compliance.
Responsible for reviewing professional coding accuracy and quality and educational feedback to coders and providers.
Conducts coder QA and education as part of identified remediation.
Collaborates with management on development of individual or group performance improvement plans related to billing compliance or coding issues.
Develops or reviews internal workflow or pathway directives that impact coding and charge capture to include system edits.
Conducts coder pre-production QA and education.
Prepares coder content and curriculums and presents coding curriculums.
Reviews and prepares documentation for educator feedback sessions.
Provides recommended improvements to documentation templates.
Prepares and presents coding and regulatory updates.
Maintains operational workflow pathways and assists coding leads as needed.
Maintains the coding resources shared library.
Utilizes knowledge of the revenue cycle and analyzes coding data to assist with the QA selection process.
Assists in reviews of coding related edits and claim denials.
Creates tracking and trend reports associated with the initiatives.
Maintains audit software and database updates.

High school diploma or equivalent.
Relevant post-secondary education or equivalent hands-on experience in lieu of a degree.
National certification and minimum of 5 years’ experience in physician coding, anesthesia/pain management, surgery and E/M, and ICD-10, with experience in academic settings.
National coding certification (AHIMA, AAPC).
Clinical certification or experience preferred.
Compliance auditing and anesthesia specialty coding education experience.
Experience in revenue cycle and claim processing.
Experience in physician billing compliance preferred.
Strong presentation and analytical skills.
Proficient in Excel, Word, and PowerPoint preferred.
Experience managing multiple clients or projects simultaneously with a high level of attention to detail.
Maintains confidentiality of sensitive information concerning patients, physicians, employees, clients, and vendors.
Ability to communicate professionally with all levels of management.
Excellent written and oral communication skills are necessary to produce and deliver quality training.
Excellent technical writing skills for development, implementation, and maintenance of documentation.
Travel may be required.

This position is eligible for an annual bonus. Bonuses are not guaranteed and are awarded based on company and individual performance.

Anesthesia Coding QA Specialist III

Key skills