Inpatient Coding Quality Reviewer- Hospital at Guidehouse in Boise, Idaho, United States Job Description Job Family : General Coding Travel Required : None Clearance Required : None What You Will Do: The Coding Quality Reviewer shall report directly to the Internal Quality Control Director and will be responsible for accessing and reviewing the medical record documentation, coding and abstracting accuracy as defined in quality review policies and facility guidelines utilizing ICD-10 CM/PCS and CPT coding classification systems. Review of patient records will be conducted utilizing the facility EMR, scanning technology and/or other established methods. All reviews will be entered daily into Guidehouse proprietary quality review tracking and trending software and will respond to coder rebuttals in a timely manner (timeline defined in quality review policies and procedures). Will also write appeals letters based on clinical validation. This position will perform any and all related job duties as assigned. This position is 100% remote. + Ensure coding quality review percentage or number of accounts per coder (as noted review assignment list) for each coder's work is conducted monthly for facilities the reviewer is assigned. + Coding quality review will be conducted to identify abstracting (to include dc disposition and POA indicators), ICD-10-CM, ICD-10-PCS, CPT, modifier, and HCPCS coding errors for codes assigned by the coding team (see quality review policies for review details). + Reviewer will run coder productivity reports (where applicable) to pull random sample accounts for review and to ensure review numbers or percentages are met + Review coding and abstracting (as defined by the facility/client) on patient types assigned to review: inpatient, ambulatory surgery, observation, emergency room with or without E/M levels, clinic, ancillary, diagnostics, etc to assure 95% coder accuracy (or as stipulated by client contract). + Become familiar with any facility specific coding guidelines and know where to access. + Required to read all Coding Clinics and CPT Assistant updates published by the education team and stay abreast of all new coding guidelines. + Ensure code recommendations entered into GuideAudit are supported by quoting AHA official Coding guidelines, Coding Clinics, CPT Assistant and/or other official coding references. Reviewers shall also document the specific record documentation that supports any code recommendation. + Notify each coder when monthly review has been completed and respond to cod To view full details and how to apply, please login or create a Job Seeker account
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