Quality Analyst- IPDRG

Greeting From Optum!!

Optum is hiring Quality Auditors for IPDRG Coding in Hyderabad ,Chennai & Noida

Medical Coding QA - IPDRG

Requirements

• Education Background:
• Graduate or Postgraduate in: Life Sciences, Allied Medicine (BHMS, BAMS, BPT, Dental Grads, Pharmacist, Nursing)
• Certification:
• Should be a certified coder AAPC / AHIMA – CCS/CPC/CPC-H/CCS-P
• Good in English communication
• Thorough knowledge of medical terminology, human anatomy/ physiology, pathophysiology
• Should have understanding of interpreting the medications and dosages.
• Should have minimum of 6 yrs. coding experience in relevant specialty.
• Should be able to provide proper and detailed feedback on errors and conduct/provide training based on error trends.
• Should be able to participate/conduct/lead calibrations between SMEs, auditors and trainer group.

Roles and Responsibilities post training:

• Auditing coded medical records using the ICD-10 and CPT.
• Know and adhere to HIPAA regulations.
• Recognize, interpret and evaluate inconsistencies, discrepancies and inaccuracies in the medical data received and appropriately alert and/or query the responsible party, coder and supervisor.
• Meet auditor quality and productivity standards and deadlines/turnaround times set up for the process.
• Educate coders through feedback on errors.
• Analyze, report and conduct sessions on error trend observed.
• Conduct/participate/lead calibration calls between SMEs, auditors and trainers.
• Report malpractices noticed during auditing of any coder.
• Educate coders on coding updates.
• Carefully demarcates between educational feedback and errors.
• Reviews rebuttals with integrity.