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Über
The role of the Quality Assurance Coordinator (QA Coordinator) is to monitor and audit medical record documentation, coding and quality measures for compliance and accuracy. It is critical for the QA Coordinator to have knowledge of 5 STAR, PQRS, HEDIS, CMS coding guidelines, and coding/documentation and billing standards and regulations. 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
Provide support for quality assessment and performance improvement activities that include quality monitoring, evaluation, and facilitation of performance improvement projects. Follow most recent documentation and coding guidelines. Use only pre‑approved source documents as validation for recommendations on documentation that meets the technical specifications in support of a measure. Assist with all quality measures initiatives – working with the PCP offices in capturing the data to support the variables. Work on Gap reports for 5 STAR and assist with the ACO GPRO quality measures projects as they become relevant and assist with all quality initiatives as needed. Process and manage member and provider communications as appropriate to each project. Assist in teaching any office staff and/or providers in proper documentation and coding guidelines as necessary. Report any issues to Quality, Compliance and Operations as necessary. Respond to inquiries regarding this area of expertise. Accurately enter 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. Assist in all RAPS submission projects as they occur, if needed in backup to the CCDIs. Assist in the preparation of quality and safety data reports for committees and meetings. Prepare meeting materials and create meeting quality improvement minutes when warranted. Perform quality education to providers/staff. Perform all other coding and documentation reviews and/or projects as asked and assist/coordinate 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. 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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