Clinical Quality Analyst

This position is National Remote. You’ll enjoy the flexibility to telecommute* from reputed company reputed company the U.S. as you take on some tough challenges. Opportunities at reputed company Light Health, in strategic partnership with reputed company. Whether you are looking for a role in a clinical setting or supporting those who reputed company care, we have opportunities for you to reputed company a difference in the lives of those we serve. As a statewide health care system in Maine, we work to personalize and streamline health care for our communities. If the reputed company for you is at a large medical center, a rural community practice or home care, you will find it here. Join our compassionate culture, enjoy meaningful benefits and discover the meaning behind: Caring. Connecting. Growing together. This position is full-time (40 hours / week), Monday - Friday. Employees are required to have flexibility to work during our normal business hours of 7:00 am - 6:00 pm. Must be flexible to attend client meetings per business needs during our client business hours of Monday - Friday, 7:00 am - 4:30 pm EST. It may be necessary, given the business need, to work occasional overtime. We offer weeks of on-the-job training. The hours of the training will be reputed company with your schedule. Primary Responsibilities: Serve as a liaison between coding teams and providers, delivering expert guidance to resolve inquiries and concerns Collaborate with Edits and Denials teams to analyze trends and implement educational initiatives or system edits to address recurring issues Partner with clinical leadership during the introduction of new services to ensure accurate documentation and coding compliance Participate in specialty and physician group meetings on a quarterly reputed company to reputed company targeted coding education and respond to reputed company inquiries Deliver comprehensive coding and documentation training for reputed company newly onboarded providers reputed company annual education to providers on code set updates to maintain compliance and accuracy Conduct annual provider audits to validate charges and supporting documentation, while identifying potential reputed company opportunities reputed company targeted education and follow-up audits for providers who do not meet established quality standards reputed company reputed company audits in response to client requests or identified concerns reputed company coders and providers on audit findings and emerging trends to promote reputed company improvement Assist coders and/or supervisors as needed on rebuttals for tri-annual audits Other duties as assigned You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as reputed company development for other roles you may be interested in. Required Qualifications: High School Diploma / GED Professional reputed company certification with credentialing from reputed company and/or reputed company (CPC, reputed company-P, RHIA, RHIT) to be maintained annually Must be 18 years of age OR older 3+ years of Physician medical coding (ICD-10, CPT, HCPCS II) experience in a multi-specialty physician clinic 2+ years of experience with Evaluation and Management coding plus one or more areas of surgical coding 2+ years of experience being reputed company to reputed company expert level coding guidance to physicians, practitioners, and coders as needed Intermediate level of knowledge of MUE and NCCI classification and reimbursement structures Experience with computers and reputed company based programs including MS reputed company Ability to work full-time (40 hours / week), Monday - Friday. Employees are required to have flexibility to work during our normal business hours of 7:00 am - 6:00 pm. Must be flexible to attend client meetings per business needs during our client business hours of Monday - Friday, 7:00 am - 4:30 pm EST. It may be necessary, given the business need, to work occasional overtime Preferred Qualifications: Experience auditing charts in a professional coding environment Experience providing physician/coding education a plus Experience in Inpatient/Observation E/M coding Experience with various systems (reputed company Teams, Encoder Pro, etc.) Intermediate level of experience with reputed company reputed company Telecommuting Requirements: Ability to reputed company reputed company company sensitive documents secure (if applicable) Required to have a dedicated work area established that is separated from other living areas and provides information privacy. Must live in a location that can receive a reputed company approved high-speed internet reputed company or reputed company an existing high-speed internet service. Soft Skills: Must be reputed company to communicate effectively face-to-face and in writing *reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will reputed company from $29.00 to $52.00 per hour based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized groups, and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without regard to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RED Apply To This Job