Job Summary
A healthcare company needs applicants for an opening for a Telecommute Coding Quality Review Team Lead in Nashville.
Core Responsibilities of this position include:
- Performs coding quality reviews including appeal escalation and communication of the account outcomes
- Performs internal quality reviews on CQRs and reporting to CQR Management
- Acts as the Subject Matter Expert to assist with development, testing and maintenance of such tools
Qualifications for this position include:
- Experience with extensive regulatory coding (ICD-9-CM, ICD-10-CM, ICD-10-PCS, CPT-4, Modifiers, MS-DRGs, POA assignment and where applicable APR-DRGs) and associated reimbursement knowledge
- Ability to analyze trends in CMI and determine root cause and address as appropriate
- Communicates professionally, clearly, proactively, and concisely with all key stakeholders, both individually and in group settings
- Possesses good interpersonal skills in building, negotiating, and maintaining crucial relationships
- Uses appropriate interpersonal styles and methods to reduce tension or conflict between two or more people
