US Anesthesia Partners REMOTE - Coding Quality Review Specialist in Dallas, Texas
U.S. Anesthesia Partners (USAP) is the largest single-specialty anesthesia practice in the country with over 4,000 clinical providers and associates. By joining our team you will participate in a highly collaborative and dynamic environment. As an organization we are mission focused on delivering the highest quality in patient care and you will be directly supporting our talented clinical team. We extend this same commitment to quality to our associates and supply tools and resources that will ensure we win in the healthcare marketplace and support of USAP.
We are proud of our inclusive people culture that supports our associates to perform at their best. USAP is an equal opportunity employer. Candidates with physician services or related health care experience is a plus. We offer a competitive benefits package. All new hires must complete a background and drug screen before starting work with US Anesthesia Partners.
The individual in this role will support our QA process. Responsibilities include the reviewing of pro-fee coding accuracy and quality and involvement with the coders in which they personally QA. The function of this role supports, but is not limited to, coders, team leads, supervisors and operations managers. Assist in trainings and provider education if needed.
The position requires strong communication and analytical skills as well as the ability to work independently while meeting required due dates.
This position may work remotely.
Retrospective and Prospective Coding QA Reviews
Complete all quarterly, monthly or project-based QAs on assigned coders in a timely manner.
Case Discrepancy Analysis and reporting
Complete tracking workbooks with feedback to be turned in timely as per P&P.
Attain and ensure defined green zone accuracy from coders being reviewed for CPT/ICD-10.
Report and escalate outliers as defined in the coding QA P&P
Provide detailed findings for educational opportunities in collaboration with assigned Educators.
Assists with the development of coding educational materials and training for use both internal and external to the department, including physicians
Identify clinical documentation insufficiencies that impact code assignments
Identify and escalate inconsistent or unclear internal workflow or pathway directives that impact code assignments or services.
Assists in the development and delivery of specialty Training and coding updates
Assists in the new coder or vendor training on platforms or coding nuances.
Assists with creating or updating the coding policies and procedures and site/location pathways
Prospective Review Pended Items
- May be asked to assist with review and feedback of pended cases or inquiries.
Other Job Responsibilities:
Assist in supporting teams with analysis and review of documentation for new business
Maintains confidentiality of sensitive information concerning patients, physicians, employees, clients, vendors, and the company.
Ensure compliance with all State, Federal, professional regulations as well as department rules, policies, and procedural manuals.
Adherence to Safety Regulations.
Adherence to HIPAA Regulations.
Maintain specialty certification CEU’s, coding updates and all regulatory or payer guidance
Other duties as assigned.
The individual in this role must possess a coding certification and have compliance auditing experience (CPC or CCS) Anesthesia or Surgical expertise is required
Must have strong analytical skills
Must have excellent communication skills
National Certification or Minimum of five years’ Experience in Anesthesia Coding, Pain Management and E/M
Experience in MS Office including Excel, Word and Power Point
Experience in Revenue Cycle and Claim denial review
Experience in various billing and EMR systems (i.e., GE, Epic)
Ability to work independently in remote environment
Minimal Travel may be required
US Anesthesia Partners, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics.
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FunctionRevenue Cycle Management