Job Summary:We are seeking a detail-oriented and experienced Coding Quality Assurance (QA) Specialist with a strong background in Interventional Radiology (IR). This role ensures the accuracy, completeness, and compliance of coding practices. The specialist plays a critical part in identifying trends, minimizing revenue leakage, and supporting coder development through audits and feedback.Key Essential Functions and Tasks:- Conduct routine and focused audits on IR encounters to ensure adherence to coding guidelines, payer requirements, and internal policies.- Validate CPT, ICD-10-CM, and HCPCS codes for IR procedures (e.g., vascular access, embolization, biopsies, drainage).- Analyze audit results and provide detailed, constructive feedback to coders.- Identify error trends and deliver targeted training or refresher sessions as needed.- Collaborate with coding managers, providers, and compliance teams to resolve documentation or coding issues.- Stay current on industry standards (AAPC, AHIMA, CMS, AMA) and payer-specific updates relevant to IR.- Maintain thorough audit records and contribute to monthly QA and coding accuracy reports.- Support pre-bill reviews and serve as a resource for complex IR coding questions.- Assist in developing and refining QA tools and checklists tailored for IR coding audits.Education and Experience Requirements:- Bachelors degree in a Life Science or healthcare-related field.- CIRCC certification (Certified Interventional Radiology Cardiovascular Coder) - Required.- Minimum 3 years of medical coding experience, including 2 years specific to Interventional Radiology.- Prior experience in coding quality auditing or training is strongly preferred.Knowledge, Skills, and Abilities:- Expert knowledge of ICD-10-CM, CPT, and HCPCS coding systems.- Strong grasp of medical terminology, IR-specific anatomy, physiology, and clinical procedures.- High level of accuracy and strong analytical thinking.- Excellent communication and interpersonal skills for cross-functional collaboration.- Proficiency in coding platforms, EHR systems, and audit software/tools.- Ability to manage multiple priorities in a deadline-driven environment.- Self-motivated with the ability to work independently. (ref:biojoby.com)
