Medical Coder QA (BPO)

1. Evaluate quality by assessing interactions against a defined set of criteria, including communication skills, product knowledge, problem-solving ability, professionalism, compliance with company policies and procedures, etc. Performs full quality assurance cycle, from monitoring, documenting, reporting, and facilitating audit rebuttal to meet customer quality and process requirements.
2. Meet the required number of outputs within a specified time while maintaining quality of individual work.
3. Conduct one-on-one or group coaching sessions to support agent development by providing objective feedback, focusing on areas of improvement and recognizing areas of excellence.
4. Participates in calibration and Inter-Rater Reliability sessions (IRR) with internal and external customers to ensure alignment in process and/or audit methodology.
5. Compiles, prepares, and documents work instructions, workflows, and reference guides to be used as job aids for the supported process or accounts.
6. Reviews, prepares, submits and maintains documentation of various reports such as but not limited to performance scores or ratings, trends analysis, or any other related ad-hoc reports to provide internal and external customers status visibility of supported process or accounts.
7. Participates in the design of the transaction monitoring form that captures customer requirements that in turn maintains customer satisfaction.
8. Identify inaccuracies in databases and adhere to issue escalation for correction or mitigation to assure data integrity of scope output produced.
9. Maintains and secure data and all individually identifiable personal information accessed through the client’s and/or ADEC’s systems to safeguard confidentiality of data.
10. Utilizes the appropriate system required for the program to gather information and answer program specific questions relevant to scope of work that will ensure accurate information dispensed or provided to the team being supported.
11. Participates in continuous learning business methodologies and programs to develop proficiency in scope of work.
12. Ensures compliance to company rules and regulations, which shall include but not limited to the Employee Code of Discipline, the policies on Quality Management System (QMS), Information Security Management System (ISMS), Environment Health & Safety (EHS), and Environmental Management System (EMS), Data Privacy Act (DPA); and other duties and responsibilities prescribed for all ADEC employees.
13. Ensures compliance of all Non-Conformity Corrective Action Preventive Action Concessions (NCAPACs) and all other audit findings within the prescribed period.
14. Reports security incidents and/or any identified security weaknesses.
15. Performs other tasks that may be assigned from time to time.

QUALIFICATIONS;
 Completed 4-year medical-allied course
 3-5 years working experience in Medical Coding at least 2+ years with QA experience and/or QA coach in a healthcare BPO setting
 Experience in Training/Subject Matter Expert is preferred
 AHIMA CCS or AAPC Certification is required
Functional Competencies
 Intermediate technical credibility. Able to adapt and meet some complex or non-routine situations
 Basic results orientation and accountability. Checks on own work to ensure all steps are completed accurately, takes action to correct substandard work, and takes pride and ownership in one's work
 Basic critical thinking. Identifies sources of data and information, and learns where to find the most relevant information for solving problems
 Basic problem solving and decision making. Asks appropriate questions to define decisions to be made
 Basic organizational awareness. Understands and uses the organization's structures, rules, networks, processes, methods or operations to achieve results
 Basic external awareness. Keeps oneself updated of developments in other parts of the organization; and exhibits awareness of external realities
Leadership Competencies
 Basic leading others. Demonstrates leadership through personal actions

Core Competencies
 Commitment to the Company’s vision & mission
 Customer Focus, Excellence, Respect, Teamwork, Integrity, Commitment (CERTIC)
 Excels at operating in a fast-paced and diverse environment
 Demonstrated high professional and ethical standards
Basic creativity and innovation. Actively contributes to brainstorming sessions in his/her work area to generate new ideas