Remote IP Quality Reviewer

Guidehouse·Remote(United States)
Other

WFA Digital Insight

As the demand for remote healthcare services grows, so does the need for skilled professionals to ensure accuracy and quality in medical coding. With a 25% increase in remote healthcare jobs in the past year, Guidehouse's Remote IP Quality Reviewer role stands out for its focus on detail and expertise in ICD-10 CM/PCS and CPT coding classification systems. Candidates should be prepared to showcase their analytical skills and knowledge of medical coding, as well as their ability to work independently in a remote setting. With the healthcare industry expected to continue its shift towards remote services, this role presents a unique opportunity for professionals to be at the forefront of this change.

Job Description

About the Role

The Remote IP Quality Reviewer role at Guidehouse is a unique opportunity for medical coding professionals to work remotely and utilize their expertise to ensure accuracy and quality in medical records. As a key member of the team, the successful candidate will be responsible for reviewing medical records for coding accuracy and abstracting data using ICD-10 CM/PCS and CPT coding classification systems. This role requires a high level of attention to detail, analytical skills, and the ability to work independently in a remote setting.

The Remote IP Quality Reviewer will be working closely with the Internal Quality Control Director and will be an integral part of the quality control team. The role entails conducting thorough reviews of medical records, identifying areas for improvement, and providing feedback to coders. The successful candidate will also be responsible for maintaining accurate and up-to-date records, responding to coder rebuttals, and participating in quality improvement initiatives.

Guidehouse is committed to providing a supportive and inclusive work environment, and the Remote IP Quality Reviewer will be an integral part of this team. With a strong focus on professional development and growth, this role presents a unique opportunity for medical coding professionals to advance their careers and contribute to the delivery of high-quality healthcare services.

What You Will Do

  • Review medical records for coding accuracy and abstracting data using ICD-10 CM/PCS and CPT coding classification systems
  • Conduct thorough reviews of medical records to identify areas for improvement and provide feedback to coders
  • Maintain accurate and up-to-date records of quality review activities
  • Respond to coder rebuttals and participate in quality improvement initiatives
  • Utilize Guidehouse proprietary quality review tracking and trending software to enter daily reviews and track progress
  • Collaborate with the Internal Quality Control Director to develop and implement quality improvement initiatives
  • Stay up-to-date with changes in coding regulations and guidelines
  • Participate in training and professional development activities to maintain and improve coding skills
  • Provide support and guidance to junior coders and quality review staff
  • Participate in special projects and initiatives as assigned by the Internal Quality Control Director

What We Are Looking For

  • 5+ years of medical coding or review experience
  • High School Diploma (Relevant experience may be substituted for formal education)
  • Must hold one of the following active credentials: RHIT, RHIA, CCS, CPC, CIC, or COC
  • Must maintain coding credential while employed by Guidehouse
  • Must pass Guidehouse coding competency exam
  • Strong analytical and problem-solving skills
  • Ability to work independently in a remote setting
  • Excellent communication and interpersonal skills
  • Strong attention to detail and organizational skills
  • Ability to maintain accurate and up-to-date records

Nice to Have

  • Previous audit experience
  • Experience with Guidehouse proprietary quality review tracking and trending software
  • Knowledge of medical terminology and disease processes
  • Experience with electronic medical records (EMRs)

Benefits and Perks

  • Competitive compensation package
  • Flexible benefits package, including medical, dental, and vision insurance
  • Personal and family sick time and company-paid holidays
  • Parental leave
  • 401(k) retirement plan
  • Basic life and supplemental life insurance
  • Health savings account (HSA) and flexible spending accounts (FSAs)
  • Tuition reimbursement and professional development opportunities
  • Skills development and certification opportunities
  • Employee referral program
  • Corporate-sponsored events and community outreach programs
  • Emergency back-up childcare program
  • Remote work arrangement with flexible scheduling

How to Stand Out

  • Ensure you have a strong understanding of ICD-10 CM/PCS and CPT coding classification systems and can provide examples of your experience with these systems.
  • Develop a portfolio that showcases your coding skills and experience, including examples of your work and any relevant certifications or credentials.
  • Be prepared to discuss your analytical and problem-solving skills, as well as your ability to work independently in a remote setting.
  • Research Guidehouse's proprietary quality review tracking and trending software to understand the tools and systems you will be working with.
  • Prepare to discuss your experience with electronic medical records (EMRs) and your ability to maintain accurate and up-to-date records.
  • Be ready to provide examples of your communication and interpersonal skills, including your ability to provide feedback and guidance to junior coders and quality review staff.
  • Consider highlighting any experience you have with quality improvement initiatives and your ability to stay up-to-date with changes in coding regulations and guidelines.

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