Reveleer is hiring a
Clinical Operations QA Specialist in United States

Summary

The job is for a Clinical Operations QA Specialist at Reveleer, a healthcare data and analytics company. The role involves ensuring quality of clinical resources and providing support to the QA team. Remote work is allowed.

Requirements

• Must have a professional coding certificate through AHIMA/AAPC
• Minimum of 5 years coding experience with specific knowledge of Medicare and Commercial Risk Adjustment such as Hierarchical Condition category (HCC)
• Strong computer skills and high-speed internet access at home
• Commitment to confidentiality of patient health information
• Professional, articulate and able to work independently

Responsibilities

• Ensures all clinical resources are monitored to meet quality scores based on QA standards set by the organization
• Provides support to clinical QA and Training team to deliver excellent quality and productivity outcome
• Completes overread of chases for coders in production and provides support in completing initial QA process during onboarding
• Communicates with and provides feedback to the Training and QA team of coding error trends and assists in creating action plans to mitigate QA discrepancies
• Assists coders in resolving coding queries based on Reveleer Coding Guidelines, AHA Coding Clinics, CMS Coders Guidance on Medical Review
• Creates and maintains quality control activities: Bi-monthly quality check on performance, monthly quality assurance reviews, keeping track of QA scores and making sure that all corrections are done in a timely manner
• During the bi-monthly quality checks – able to identify outliers that needs retraining and set action plans and communicated either on one-on-one or group teaching in coordination with the training team
• Pulls reports to better understand error trends and presents to internal team for deliberation
• Collaborates and consults effectively with all levels of the QA teams to ensure adherence to policies and procedures

Benefits

$32.25 / hour compensation