Job Family:
General Coding
Travel Required:
None
Clearance Required:
None
What You Will Do:
Lead Duties (50%; approximately 20 hours/Week)
- The Lead will be responsible for assisting with the onboarding and training of pro fee reviewers to include but not be limited to resource tools, drives where facility guidelines are stored, One Note, Replicon, education portal, P&P’s, and client specific policies.
- The Lead will be responsible for creating client review training workflows and associated training materials as needed.
- The Lead will collaborate with coding operations leaders and oversee the pro fee QA pre-bill assignments
- Assist with reviewer connectivity process for new or existing clients and troubleshooting with the review team for resolution
- The lead will collaborate with onshore and offshore coding leadership to update the pro fee review assignment sheet and distribute to the review team weekly
QA Duties (50%; approximately 20 hours/Week)
- The Pro Fee quality reviewer will be responsible for reviewing the entire patient record documentation for the date of service being audited to validate the accuracy of code and abstract data elements.
- Validation of the applicable code elements.
- Ensure coding quality review number of accounts per coder (as noted on review assignment list) for each coder’s work is completed monthly.
- Coding quality review will be conducted to identify abstracting, ICD-10-CM, CPT, modifier, and HCPCS coding errors for codes assigned by the coding team (see quality review policies for review details).
- Will run coder productivity reports (where applicable) from the facility system, GuideAudit production or pull random sample accounts from the completed coding spreadsheet for review.
What You Will Need:
- Must hold one of the following active credentials: (CPC, COC, CPMA RHIT, RHIA, CCS, CIC or COC).
- Must have a high school diploma/GED. Relevant experience accepted in lieu of a degree.
- Must maintain coding credentials while employed by Guidehouse.
- Must pass Guidehouse coding competency exam.
- Must have at least 8 years of pro fee coding or review experience.
- Abide by all client policies and procedures.
- Abide by all Guidehouse policies and procedures.
- Personal responsibility, respect for self and others, innovation through teamwork, dedication to caring and excellence in customer service.
- Ability to work with Microsoft Office, Excel, and computer programs as well as company specific programs.
What Would Be Nice To Have:
- ·Auditing experience is preferred.
- Previous leadership experience.
- BS/BA is preferred
#LI-DNI
The annual salary range for this position is $74,000.00-$124,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
What We Offer:
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Benefits include:
Medical, Rx, Dental & Vision Insurance
Personal and Family Sick Time & Company Paid Holidays
Position may be eligible for a discretionary variable incentive bonus
Parental Leave
401(k) Retirement Plan
Basic Life & Supplemental Life
Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
Short-Term & Long-Term Disability
Tuition Reimbursement, Personal Development & Learning Opportunities
Skills Development & Certifications
Employee Referral Program
Corporate Sponsored Events & Community Outreach
Emergency Back-Up Childcare Program
