Performs coding and documentation review of records to ensure compliance with company billing policies and procedures, contractual requirements and governmental billing regulations.
Essential Duties and Responsibilities:
Analyzes and validates medical records documentation to ensure coding data is compliant with coding guidelines
Performs audits ranging from moderate to complex
Utilizes data analysis and extraction tools to evaluate billing transactions and identify potential billing errors
Identifies and researches audit finding presenting concerns and solutions to appropriate leadership
Ensures all information related to findings are appropriately documented according to company policies and procedures
Completes most routine audit functions with minimum supervision
Other projects and duties as assigned
Ability to perform detailed mathematical calculations and understanding of mathematical concepts
Ability to manage multiple tasks simultaneously, work independently with minimal supervision and meet stringent deadlines
Attention to detail/excellent follow skills
Proactive, self motivated and quality results oriented
Working knowledge of billing requirements to include procedural and diagnostic coding
Education and/or Experience: (includes certificate & licenses)
Medical billing knowledge preferred
Strong working knowledge of MS Excel
Experience working with IDEA Data Analysis Software
Must be able to successfully pass National Agency Check with Inquiries (NACI) background investigation
This job description supersedes all prior job descriptions and is intended to describe the general content and essential requirements for the position listed above. It is not to be construed as an exhaustive statement of requirements, duties and responsibilities. Management reserves the right to add or change the duties of this position as required at any time.
QTC Management Inc. is a VEVRAA Federal contractor and an Equal Opportunity Employer. The company has an ongoing commitment to affirmative action and the creation of a workplace free of discrimination, harassment and retaliation. The company recruits, hires, trains, and promotes individuals in all job titles without regard to race, color, creed, religion, ancestry, national origin, age, sex, sexual orientation, people with disabilities protected under law, and protected veteran status.
QTC Management, Inc.