Manager Quality Medical Coding @ Gebbs Healthcare

Job Description

Excellent domain expertise and process knowledge about RCM for Hospital facility/Physician.

Understanding of Facility hospital verses Physician coding with indepth knowledge of the specialties - E&M-IP/OP.

Knowledge of EM IP/OP, APC for optimizing the reimbursement and element of UHDDS and guidelines, Level of service determination with emphasis on Physical Examination & Medical Decision Making in Documentation guidelines, hospital E&M coding - initial/subsequent visit

Good knowledge of Human Anatomy, Physiology, Pathophysiology, Pharmacology, Diagnostic Studies, Conservative and Surgical Treatments. Understanding of Operative Reports and other report types with documentation requirements.

Aware of consequences of risky practices like up-coding and down-coding, Fraud and abuse, inflated documentation, HIPAA and CLIA rules mandating claim transmission.

Responsibilities

Will be responsible for supervising and managing a team of 100+ QAs

Create an inspiring team environment with an open communication culture

Design QA capacity planning as per project requirement

Delegate tasks and set deadlines

Manage Quality of OP (ED/EM/SDS/ANC/OBV), ProFee Surgery & EM, and IP DRG projects

Quality control as per client SLA

Ensure effective implementation of organizations Quality Management System

Monitor team performance and report on metrics

Performing random audit of auditor

Perform RCA on audits observations. Identify knowledge gaps and develop an action plan with quality leads and operation managers

Discover training needs and provide coaching to QAs

Listen to team members feedback and resolve any issues or conflicts

Recognize high performance and reward accomplishments

Encourage creativity and business improvement ideas

Suggest and organize team building activities

Identify improvement opportunities and initiate action plans for improvement

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Rs 0 - 50K PM Rs 50K - 1 LPA Rs 1.0 - 1.5 LPA Rs 1.5 - 2.0 LPA Rs 2.0 - 2.5 LPA Rs 2.5 - 3.0 LPA Rs 3.0 - 3.5 LPA Rs 3.5 - 4.0 LPA Rs 4.0 - 4.5 LPA Rs 4.5 - 5.0 LPA Rs 5 - 6 LPA Rs 6 - 7 LPA Rs 7 - 8 LPA Rs 8 - 9 LPA Rs 9 - 10 LPA Rs 10 - 12 LPA Rs 12 - 14 LPA Rs 14 - 16 LPA Rs 16 - 18 LPA Rs 18 - 20 LPA Rs 20 - 22 LPA Rs 22 - 24 LPA Rs 24 - 26 LPA Rs 26 - 28 LPA Rs 28 - 30 LPA Rs 30 - 32 LPA Rs 32 - 34 LPA Rs 34 - 36 LPA Rs 36 - 38 LPA Rs 38 - 40 LPA Rs 40 - 42 LPA Rs 42 - 44 LPA Rs 44 - 46 LPA Rs 46 - 48 LPA Rs 48 - 50 LPA Rs 50 - 75 LPA Rs 75 Lakh - 1C PA Rs 1 Crore+ PA

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Keyskills:   udp medical sds anatomy hipaa ip drg us healthcare hcc ems icd mac evaluation coding mip denial management cpc drg denial coding rcm ed tcp rrc python human anatomy e cpt ip physiology rlc hcpcs m ehr lps medical coding r ops surgery