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  • Full Time
  • India

HealthRecon Connect provides technology-enabled Revenue Cycle Management solutions to US healthcare providers. The company leverages over 30 years of deep domain expertise, machine learning, AI, cutting-edge analytics, and automated workflows that help improve cash flow, patient outcomes and enable peace of mind for their clients. At HealthRecon Connect, day after day, we not only hold ourselves accountable for setting and maintaining high standards, but we also passionately strive for the highest achievement, customer delight and thrive on the challenge of high expectations and commitment to excel.

HealthRecon was certified a Great Workplace by Great Place to Work® Sri Lanka for five consecutive years and was adjudged one of the 40 Best Workplaces in Sri Lanka in 2021. HealthRecon is also a Signatory Participant of the United Nations Global Compact.

We are seeking a meticulous and experienced Outpatient Coding Quality Reviewer to join our team. The successful candidate will be responsible for ensuring the accuracy and compliance of outpatient medical coding processes within our organization. The role involves conducting thorough reviews of outpatient medical records, coding assignments, and documentation to identify any discrepancies or errors. The Outpatient Coding Quality Reviewer will collaborate closely with outpatient coding staff, healthcare providers, and other stakeholders to implement corrective actions and improve overall outpatient coding quality.

Please review the criteria and other information listed below thoroughly prior to applying and pay specific attention to the work week, shift details and other features of the job. Due to the large volume of applications we receive, all applications will be reviewed in the order in which they were received and only the candidates short-listed for the first round of interviews will be contacted. Thank you for your understanding.

Job Vacancy:
Outpatient Coding Quality Reviewer

Work Week:
Monday to Friday

Shift Window:
7:30 PM – 4:00 AM IST (Night Shift)

Other Features:
Full-time
US calendar applicable

Key Responsibilities:

  • Conduct comprehensive reviews of outpatient medical records, coding assignments, and documentation to assess accuracy, completeness, and compliance with outpatient coding guidelines and regulations.
  • Identify discrepancies, errors, or patterns of non-compliance in outpatient medical coding practices and documentation.
  • Analyze outpatient coding trends and data to identify areas for improvement and develop strategies to enhance outpatient coding accuracy and efficiency.
  • Collaborate with outpatient coding staff, healthcare providers, and other relevant stakeholders to address outpatient coding issues, implement corrective actions, and provide education and training as needed.
  • Develop and maintain quality assurance protocols, standards, and procedures for outpatient medical coding activities.
  • Stay updated on changes in outpatient coding regulations, guidelines, and best practices, and ensure compliance with relevant industry standards (e.g., ICD-10-CM, CPT, HCPCS).
  • Participate in internal and external audits and reviews to evaluate outpatient coding accuracy and compliance with regulatory requirements.
  • Prepare reports and presentations summarizing outpatient coding review findings, trends, and recommendations for improvement.
  • Provide support and guidance to outpatient coding staff regarding outpatient coding queries, complex cases, and outpatient coding-related inquiries.
  • Foster a culture of continuous improvement and quality excellence within the outpatient coding department.

 

Qualifications/Criteria:

  • Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification required.
  • Minimum of 3 years of experience in outpatient medical coding (ED, SDS, Ancillary, OBS, etc.).
  • Minimum of 2 years of experience in outpatient auditing.
  • Thorough understanding of outpatient coding principles, guidelines, and regulations (e.g., ICD-10-CM, CPT, HCPCS), as well as compliance requirements (e.g., HIPAA, HITECH).
  • Proficiency in using outpatient coding software and electronic health record (EHR) systems.
  • Strong analytical skills and attention to detail, with the ability to identify outpatient coding discrepancies and trends.
  • Excellent communication and interpersonal skills, with the ability to collaborate effectively with diverse stakeholders.
  • Demonstrated ability to work independently, prioritize tasks, and manage multiple outpatient coding projects simultaneously.
  • Knowledge of outpatient healthcare reimbursement methodologies and outpatient revenue cycle processes is a plus.
  • Knowledge of professional fee (profee) coding practices is an advantage.
  • Commitment to upholding ethical standards, integrity, and confidentiality in handling sensitive outpatient medical information.

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