QA I Coding Operations

Overview The QA I, is an integral member of the Risk Adjustment Coding Team. The QA position monitors & reports on the accuracy of all coding performed by Cotiviti coders and/or third party partner coders. This position provides direct coaching and feedback to coders. The QA I conducts QA and audit reviews, supports remediation for risk adjustment coding services, and ensures compliance with quality standards. Responsibilities Provides Quality Assurance feedback by working as a liaison between Coder I, Coder II and the Team Lead to ensure coding is complete and accurate. Reviews a defined percentage of the Coder I and Coder II work to ensure quality standards are met and maintained. Completes chart or encounter review for proper HCC-mapped diagnosis coding from various chart types (physician, facility, non-facility). Completes chart or encounter review for proper HCC-mapped diagnosis coding performedprospectively, concurrent, or retrospective. Ensures that all coding performed follows client specific or industry standard coding guidelinesand reflects an accurate and complete representation of the documentation within the medicalrecord. Professionally communicates findings, errors, and any suggestions to all staff to facilitate ongoing communications and efficient department operations. Completes internal audits as necessary to support quality accuracy. Reviews internal system reports on the quality of work for all assigned coding staff. These reports are reviewed daily, w