About the company
Guidehouse is a global AI-led professional services firm delivering advisory, technology, and managed services to the commercial and government sectors. With an integrated business technology approach, Guidehouse drives efficiency and resilience in the healthcare, financial services, energy, infrastructure, and national security markets. Built to help clients across industries outwit complexity, the firm brings together approximately 18,000 professionals to achieve lasting impact and shape a meaningful future.
Job Summary
What you will do:
šPlans, monitors, direct and evaluate QA production on a daily basis. Ensures that daily schedules are met and communicates with Director, and Coding Operations if situations occur that hinder meeting deadlines. If system issues or other emergencies delay QA, an implement measures/schedules to return to established schedules at the earliest possible time. This should be done closely with each quality specialist to ensure the needs are met and that satisfy our client requirements. šResponsible for ensuring that the QA communicates a valid, workable schedule for his or her client each week. Accurate, sensible & on-time.**If this doesnāt happen properly, itās the responsibility of the Lead QA Specialist to make it happen promptly. šReview medical record documentation for accuracy in code assignment of the primary/secondary diagnosis and procedures using ICD-9-CM and CPT-4 coding conventions. Sequence the diagnosis and procedures using coding guidelines. When applicable, ensure MS-DRG/APC assignment is accurate. Abstract and compile data from medical records for appropriate optimal/complaint reimbursement for hospital and/or professional charges. This involves reviewing code assignments that are not straightforward or the documentation in the record is inadequate, ambiguous, or unclear for coding purposes.
What you will need:
šMinimum of 5+years of experience on medical coding with Anesthesia coding šShould be certified from AAPC/AHIMA šHands on experience in Anesthesia šMust be a Graduate šEnsure data collection capability in relevant systems and business processes šStrong analytical, research, and organizational skills required. šICD-10-PCS coding systems, ensuring accuracy and compliance with all regulatory and reimbursement requirements
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