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Über
The QA Coordinator uses their knowledge of ICD‑9/ICD‑10, CPT, and documentation guidelines, as well as billing knowledge, to assist in any and all coding and documentation audits and/or billing functions as determined by the Compliance, Operations, and/or Quality department(s). Additionally, the QA Coordinator participates in company‑wide quality initiatives.
Key Duties & Responsibilities
The QACoordinator is responsible for providing support for quality assessment and performance improvement activities that include quality monitoring, evaluation, and facilitation of performance improvement projects.
Follows most recent documentation and coding guidelines.
Uses only pre‑approved source documents as validation for recommendations on documentation that meets the technical specifications in support of a measure.
Assists with all quality measures initiatives – working with the PCP offices in capturing the data to support the variables.
Works all Gap reports for 5 STAR and assists with the ACO GPRO quality measures projects as they become relevant and assists with all quality initiatives as needed.
Process and manage member and provider communications as appropriate to each project.
Assists in teaching any office staff and/or providers in proper documentation and coding guidelines as necessary.
Reports any issues to Quality, Compliance and Operations as necessary.
Responds to inquiries regarding this area of expertise.
Accurately enters all identified and validated measures into the practice’s EMR – if necessary to aid the CCDIs, may enter validated conditions as indicated by the CCDIs into the EMR.
Assists in all RAPS submission projects as they occur if needed in back‑up to the CCDIs.
Assists in the preparation of quality and safety data reports for committees and meetings.
Prepare meeting materials and create meeting quality improvement minutes when warranted.
Performs quality education to providers/staff.
Performs all other coding and documentation reviews and/or projects as asked and assists/coordinates strategies as defined by the department head or assistant.
Required Skills/Abilities
Excellent verbal and written communication skills.
Excellent organizational skills and attention to detail.
Excellent time management skills with a proven ability to meet deadlines.
Proficient with Microsoft Office Suite (Word and Excel) or related software.
Communication / coordinate sharing of pertinent information accurately.
Critical thinking / problem solving / computer skills.
Proficient knowledge and experience working with an EHR system.
Ability to travel.
Ability to read and analyze medical records.
Knowledge and understanding of ICD‑9/10, CPT codes and QIP measures – CPC or CSSP is a plus.
Understands documentation, coding and billing guidelines as well as how to read the technical specifications on all quality initiatives.
Supervisor Responsibilities
None.
Education and Experience
Prefer candidate to have some medical record or quality background and current ICD‑9/10 coding education.
1–2 years of documentation or medical records experience in any part of the medical continuum.
Must demonstrate the ability to utilize Excel and WORD via assessment at interview.
Physical Requirements
Prolonged periods of sitting at a desk and working on a computer.
While performing the duties of this job the employee is regularly required to sit, use hands and arms, talk and hear.
Must be able to lift up to 10 pounds at times.
Benefits
Health insurance
Dental insurance
Vision insurance
Life insurance
401(k)
Paid time off
Schedule
8‑hour shift
Day shift
Monday to Friday
Job Type Hybrid
Equal Opportunity Palm Primary Care is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. Palm Primary Care makes hiring decisions based solely on qualifications, merit, and business needs at the time.
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Sprachkenntnisse
- English
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