AM - HIM Services

About Us:

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. 

We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.  

ESSENTIAL DUTIES AND RESPONSIBILITIES: 
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

Roles and Responsibilities:

• Playing an integral part of the quality assurance team and responsible for efficient and effective management of day-to-day QA operations.
• Overseeing quality audit activities to ensure customer service, accuracy, and quality expectations are met.
• Be the primary contact for quality-related questions relating to Client services and operations.
• Reviewing quality audit reports to identify specific error trends and root causes, investigate discrepancies as per coding/quality guidelines, and implement corrective and preventive action plans.
• Managing multiple quality audits and creating solutions from available information.
• Owning challenging people and project assignments independently with ease and delivering fulfilment of work across the company.
• Total ownership and leadership responsibility for team development.
• Resource Planning for QA function based on business volume forecasting.
• Continual improvement of quality processes through regular interactions with clients and coding teams.
• Preparing quality manuals, audit checklists, training kits, and other documentation for QA processes.
• Preparing month-end quality reports, accuracy scorecards, and error trend analysis for clients.
• Evaluating trends and comparisons on month-end quality metrics/accuracy rates for each client.
• Conducting calibration sessions with coding teams and clients to ensure consistency in quality standards.

Required Expertise & Qualification:

• Life Science graduation or any equivalent graduation with Anatomy/Physiology as main subjects.
• 7–10 years of overall coding/quality assurance experience, out of which a minimum of 2 years in team handling of a team.
• Should be a certified coder from either AAPC or AHIMA.
• Strong knowledge of quality audit methodologies, error categorization, and RCA/CAPA processes.
• Good communication skills, both verbal and written.
• Strong leadership & organizational skills.
• Hands-on experience in generating analysis using MS Office – Excel, Word, and MS PowerPoint.

PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.