GeBBS Healthcare Solutions - Senior Manager - Quality Coding - IP DRG Vertical

Job Description:

Experience: 10-14 Years

- Excellent domain expertise and process knowledge (RCM for Facility/Hospital).

- Knowledge of ICD-10-CM, ICD-10-PCS coding guidelines, UHDDS guidelines, Principal Diagnosis, CCs and MCCs, DRG selection and validation, POS indicators, Query Process, MS DRG, APR DRG, SOI, ROM.

- Knowledge of medical record documentation guidelines and federal compliance guidelines in Inpatient Hospital setting.

- Knowledge of quality processes in Coding.

Skills:

- Strong interpersonal, good communication, presentation, and analytical skills, quality focused and data-driven approach.

- Ability to manage team size of 40-50 employees. Analytical approach to problem solving.

Behavior:

- Disciplined, positive attitude, & punctuality, team player, collaborative approach.

- Experience must in IP DRG Coding with at least one relevant certification from AAPC or AHIMA (CCS and CIC preferred).

- At least 1-2 years experience in team management.

- Exposure to coding audit functions and mechanisms, developing training contents.

- Worked on quality improvement projects.

- Should have experience and understanding of coding workflows and prominent EMR(s) and CAC systems.

- Should be very familiar with utilization of CMS and industry guidelines for IP DRG coding.

- Will be responsible for supervising and managing a team of 40-50 QAs and QALs

- Create an inspiring team environment with an open communication culture

- Design QA capacity planning as per project scope requirement

- Delegate tasks and set deadlines

- Manage Quality of multiple IP DRG Coding projects

- Analyze internal and client quality data and suggestion remedial action plans

- Implement Quality control mechanisms as per client quality process

- Ensure effective implementation of organizations Quality Management System

- Monitor team performance and report on metrics

- Performing random audit of auditors

- Perform RCA on audits observations, identify knowledge gaps, and develop an action plan with quality leads and operation managers

- Provider regular feedback to Training team to update content

- Discover training needs and provide coaching to QAs and Trainers

- Listen to team members feedback and resolve any issues or conflicts

- Recognize high performance and reward accomplishments