Manager Quality Medical Coding @ Gebbs Healthcare

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Manager Quality Medical Coding

Gebbs Healthcare
10 - 13 years
Aurangabad
20 days ago
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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 - EM-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 EM 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 organization s 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

Job Classification

Industry: Medical Services / Hospital
Functional Area / Department: Healthcare & Life Sciences
Role Category: Health Informatics
Role: Medical Biller / Coder
Employement Type: Full time

Contact Details:

Company: Gebbs Healthcare
Location(s): Aurangabad

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Keyskills: Auditor Business improvement RCA Coding Medical coding HIPAA Manager Quality Control Team building Auditing Capacity planning

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Functional area / Department (*):

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Attach ResumeMax 2.38 MB (RTF, PDF, DOC, DOCX formats only parsed)

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Gebbs Healthcare

Gebbs Healthcare Solutions Pvt. Ltd. GeBBS is an ISO 9001 certified healthcare outsourcing solutions firm based in Englewood Cliffs, NJ, with multiple Global Delivery Centers located in Mumbai, India. We focus on providing Business Process Outsourcing (BPO) solutions to Healthcare Providers (Med...

Manager Quality Medical Coding @ Gebbs Healthcare

Home > Health Informatics