job description
Join R1 RCM as an Inpatient (IP) Quality Assurance Specialist and play a pivotal role in ensuring the highest standards of medical coding accuracy and compliance. In this dynamic position, you will review and audit inpatient medical records, collaborating with cross-functional teams to enhance coding quality across multiple specialties. This is an exceptional opportunity to grow your expertise in a collaborative, learning-driven environment while contributing to the success of a leading healthcare revenue cycle management company.
Based in the vibrant regions of Bali, including Canggu, Ubud, Denpasar, Jimbaran, Nusa Dua, Kuta, and Badung, this role offers a unique blend of professional growth and work-life balance in one of the world's most sought-after destinations. Whether you're an experienced coding professional or looking to advance your career in healthcare quality assurance, R1 RCM provides the tools, training, and support to help you succeed.
At R1 RCM, we are committed to fostering a culture of continuous improvement, innovation, and excellence. As part of our team, you will have access to ongoing professional development, mentorship programs, and a network of industry experts dedicated to your success. If you are passionate about healthcare quality and eager to make a meaningful impact, we invite you to apply and take the next step in your career with us.
Responsibility
- Conduct comprehensive audits of inpatient medical records to ensure accuracy, compliance, and adherence to coding guidelines (ICD-10-CM, CPT, HCPCS).
- Identify and document coding discrepancies, providing detailed feedback and corrective action plans to coding teams.
- Collaborate with clinical documentation improvement (CDI) specialists, physicians, and coding teams to resolve queries and improve documentation integrity.
- Develop and implement quality assurance processes, policies, and procedures to enhance coding accuracy and efficiency.
- Monitor and analyze coding trends, identifying areas for improvement and recommending training or process adjustments.
- Participate in regular team meetings and training sessions to stay updated on industry changes, regulatory updates, and best practices.
- Prepare and present audit findings and performance metrics to management, highlighting key insights and recommendations.
- Serve as a subject matter expert (SME) for inpatient coding, providing guidance and support to junior team members.
Qualifications
- Bachelor's degree in Health Information Management (HIM), Nursing, or a related field. Equivalent experience may be considered.
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification required.
- Minimum of 3 years of experience in inpatient medical coding, with a strong understanding of ICD-10-CM, CPT, and HCPCS coding systems.
- Proven experience in quality assurance, auditing, or compliance within a healthcare setting.
- Excellent analytical skills with the ability to interpret complex medical records and identify coding inaccuracies.
- Strong communication and interpersonal skills, with the ability to collaborate effectively with cross-functional teams.
- Proficiency in using coding software and electronic health record (EHR) systems.
- Detail-oriented with a commitment to accuracy, integrity, and continuous learning.