专业费用质量团队负责人
Pro Fee Quality Team Lead
职位类别：
通用编程
是否需要出差：
无需出差
是否需要安全许可：
无需安全许可
您将负责的工作内容：
主导职责（50%；约每周20小时）
- 主导将负责协助新进或现有收费审核员的入职和培训，包括但不限于资源工具、存储设施指南的驱动器、One Note、Replicon、教育门户、P&P以及客户特定政策。
- 主导将负责根据需要创建客户审核培训流程及相关的培训材料。
- 主导将与编码运营负责人合作，并监督收费质量保证（QA）的预计账单分配。
- 协助新客户或现有客户的审核员连接流程，并与审核团队协作解决相关问题。
- 主导将与岸上和海外编码领导合作，更新收费审核分配表，并每周分发给审核团队。
质量保证职责（50%；约每周20小时）
- 收费质量审核员将负责审核被审计服务日期的完整患者病历文档，以验证代码和摘要数据元素的准确性。
- 验证适用的代码元素。
- 确保每位编码员根据审核分配列表中注明的数量，每月完成其工作的审核数量。
- 进行编码质量审核，以识别编码团队所分配代码的摘要错误、ICD-10-CM、CPT、修饰符和HCPCS编码错误（详见质量审核政策中的审核详情）。
- 将从机构系统、GuideAudit生产系统中运行编码员生产力报告（如适用），或从已完成的编码电子表格中随机抽取账户进行审核。
您需要具备的条件：
- 必须持有以下任一有效资质：（CPC、COC、CPMA、RHIT、RHIA、CCS、CIC 或 COC）。
- 必须拥有高中文凭/GED。相关经验可替代学位。
- 在任职于Guidehouse期间必须保持编码资质。
- 必须通过Guidehouse的编码能力考试。
- 必须至少有8年收费编码或审核经验。
- 遵守所有客户政策和程序。
- 遵守所有Guidehouse政策和程序。
- 具备个人责任感，尊重自己和他人，通过团队合作实现创新，致力于提供关怀和卓越的客户服务。
- 能够使用Microsoft Office、Excel以及计算机程序，以及公司特定的程序。
查看英文原文
Job Family:
General CodingTravel Required:
NoneClearance Required:
NoneWhat You Will Do:
Lead Duties (50%; approximately 20 hours/Week)
- The Lead will be responsible for assisting with the onboarding and training of pro fee reviewers to include but not be limited to resource tools, drives where facility guidelines are stored, One Note, Replicon, education portal, P&P’s, and client specific policies.
- The Lead will be responsible for creating client review training workflows and associated training materials as needed.
- The Lead will collaborate with coding operations leaders and oversee the pro fee QA pre-bill assignments
- Assist with reviewer connectivity process for new or existing clients and troubleshooting with the review team for resolution
- The lead will collaborate with onshore and offshore coding leadership to update the pro fee review assignment sheet and distribute to the review team weekly
QA Duties (50%; approximately 20 hours/Week)
- The Pro Fee quality reviewer will be responsible for reviewing the entire patient record documentation for the date of service being audited to validate the accuracy of code and abstract data elements.
- Validation of the applicable code elements.
- Ensure coding quality review number of accounts per coder (as noted on review assignment list) for each coder’s work is completed monthly.
- Coding quality review will be conducted to identify abstracting, ICD-10-CM, CPT, modifier, and HCPCS coding errors for codes assigned by the coding team (see quality review policies for review details).
- Will run coder productivity reports (where applicable) from the facility system, GuideAudit production or pull random sample accounts from the completed coding spreadsheet for review.
What You Will Need:
- Must hold one of the following active credentials: (CPC, COC, CPMA RHIT, RHIA, CCS, CIC or COC).
- Must have a high school diploma/GED. Relevant experience accepted in lieu of a degree.
- Must maintain coding credentials while employed by Guidehouse.
- Must pass Guidehouse coding competency exam.
- Must have at least 8 years of pro fee coding or review experience.
- Abide by all client policies and procedures.
- Abide by all Guidehouse policies and procedures.
- Personal responsibility, respect for self and others, innovation through teamwork, dedication to caring and excellence in customer service.
- Ability to work with Microsoft Office, Excel, and computer programs as well as company specific programs.
What Would Be Nice To Have:
- Auditing experience is preferred.
- Previous leadership experience.
- BS/BA is preferred
The annual salary range for this position is $74,000.00-$124,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.What We Offer:
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Benefits include:
- Medical, Rx, Dental & Vision Insurance
- Personal and Family Sick Time & Company Paid Holidays
- Position may be eligible for a discretionary variable incentive bonus
- Parental Leave
- 401(k) Retirement Plan
- Basic Life & Supplemental Life
- Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
- Short-Term & Long-Term Disability
- Tuition Reimbursement, Personal Development & Learning Opportunities
- Skills Development & Certifications
- Employee Referral Program
- Corporate Sponsored Events & Community Outreach
- Emergency Back-Up Childcare Program
About Guidehouse
Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or . Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.
If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact . Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.
Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.
Originally posted on Himalayas