|Employer:||SCIO Health Analytics/EXL
|Skills:||DRG,ICD diagnosis/procedure codes,CPT,HCPCS
|Required Certifications:||RHIT or RHIA
|Preferred Certifications:||CCS or CPC
|Required Experience:||5 to 7 years
|Preferred Experience:||5 to 7 years
|Location:||12276 San Jose Blvd, Suite 410 Jacksonville 32223, FL, US
SCIO Health Analytics, an EXL company, is looking for an experienced Quality Analyst III - DRG Coding. This is a home office opportunity.
The Quality Analyst III oversees work performed by the DRG auditors to ensure that SCIO’s standard of accuracy is met. The analyst undertakes a quality review of random and targeted coding audits to enhance the accuracy and completeness of audits performed. Additionally, the analyst develops audit feedback sessions to all staff from routine internal audit, identifying general training trends and requirements. Demonstrated flexibility and adaptability.
Key Duties and Responsibilities:
• Responsible for reviewing the accuracy and consistency of clinical DRG coding auditors to ensure audits are appropriately marked for findings and no findings.
• Assist in mentoring Coders
• Provide updates to training and user manuals
• Recommend process changes to improve quality and performance
• Communicate with peers and management Provide root cause analysis on errors
• Conduct all job functions and responsibilities in accordance with all company Compliance, Information Security and Regulatory policies, procedures and programs.
Knowledge and Skills:
• Experience with coder tools (3M, Webstrat)
• Sound knowledge of ICD diagnosis/procedure codes, CPT, HCPCS coding guidelines
• Ensures appropriate ICD-10 coding and sequencing as it relates to the patient’s medical condition.
• Superior auditing and monitoring skills.
• Excellent decision making skills and sound judgment.
• Thorough understanding of medical terminology and human physiology.
• Strong technical knowledge and ability to learn new systems quickly.
• Excellent oral/presentation and written communication skills.
• Ability to complete tasks efficiently and resolve problems within set timelines.
• Excellent client and customer service skills.
• Ability to mentor and instruct through audits.
• Strong organizational skills and attention to detail.
• Minimum 5 years relevant DRG coding or DRG auditing experience (clinical DRG preferred)
• RHIT or RHIA certification
• CCS certification, CPC certification