Quality Improvement Coordinator - Palm Medical Centers
Orlando, FL 32822
About the Job
Job description
Department: Quality Assurance
Reports to: Quality Manager
FLSA Status: Exempt
Overview
The role of the Quality Improvement- (QI Specialist) is to monitor and audit medical record documentation, coding and quality measures for compliance and accuracy. It is critical for the QI Specialist to have knowledge of 5 STAR, PQRS, HEDIS, CMS coding guidelines, and coding/documentation and billing standards and regulations.
The QI Specialist uses their knowledge of ICD-9/ICD-10, CPT, and documentation guidelines as well as billing knowledge to assist in any and all coding and documentation audits and/or billing functions as determined by the Compliance, Operations, and/or Quality department(s). Additionally, the QI Specialist participates in company-wide quality initiatives.
Key Duties & Responsibilities:
· Provides support for quality assessment and performance improvement activities that include quality monitoring, evaluation and facilitation of performance improvement projects.
· Follows most recent documentation and coding guidelines
· Uses only pre-approved source documents as validation for recommendations on documentation that meets the technical specifications in support of a measure
· Assists with all quality measures initiatives – working with the PCP offices in capturing the data to support the variables.
· Works all Gap reports for 5 STAR and assists with the ACO GPRO quality measures projects as they become relevant and assists with all quality initiatives as needed.
· Process and manage member and provider communications as appropriate to each project.
· Assists in teaching any office staff and/or providers in proper documentation and coding guidelines as necessary
· Reports any issues to Quality, Compliance and Operations as necessary.
· Responds to inquiries regarding this area of expertise.
· Accurately enters all identified and validated measures into the practice’s EMR – if necessary to aid the CCDIs, may enter validated conditions as indicated by the CCDIs into the EMR
· Assists in all RAPS submission projects as they occur if needed in back-up to the CCDIs
· Assist in the preparation of quality and safety data reports for committees and meetings.
· Prepare meeting materials and create meeting quality improvement minutes when warranted
· Performs all other coding and documentation reviews and/or projects as asked and assists/coordinates strategies as defined by the department head or assistant.
Required Skills/Abilities:
· Excellent verbal and written communication skills.
· Excellent organizational skills and attention to detail.
· Excellent time management skills with a proven ability to meet deadlines.
· Proficient with Microsoft Office Suite (Word and Excel) or related software.
· Communication / Coordinate sharing of pertaining information accurately.
· Critical Thinking / Problem solving/Computer
· Has proficient knowledge and experience working with an EHR system.
· Ability to travel.
· Ability to read and analyze medical records.
· Knowledge and understanding of ICD -9/10 , CPT codes and QIP measures – CPC or CSSP is a plus
· Understands documentation, coding and billing guidelines as well as how to read the technical specifications on all quality initiatives.
Supervisor Responsibilities:
· None.
Education and Experience:
Prefer candidate to have some medical record or quality background and current ICD-9/10 coding education. 1-2 years of documentation or medical records experience in any part of the medical continuum. Must demonstrate the ability to utilize Excel and WORD via assessment at interview.
Physical Requirements:
· Prolonged periods of sitting at a desk and working on a computer.
· While performing the duties of this job the employee is regularly required to sit, use hands and arms, talk and hear.
Job Type: Full-time
Salary: $40,000.00 - $50,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
- On call
- Weekend availability
Ability to commute/relocate:
- Orlando, FL 32822: Reliably commute or planning to relocate before starting work (Required)
Experience:
- ISO 9001: 1 year (Required)
Work Location: In person
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