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Quality Analyst III-DRG

SCIO Health Analytics. an EXL Company, is seeking an experienced Quality Analyst III -DRG. This is a home office opportunity. The Quality Analyst III oversees work performed by the coding validation audit programs to ensure that SCIO’s standard of accuracy is met. The analyst undertakes a quality review of random and targeted coding audits to enhance the accuracy and completeness of audits performed. Additionally, the analyst develops audit feedback sessions to all staff from routine internal audit, identifying general training trends and requirements.

Responsible for reviewing the accuracy and consistency of clinical coding auditors to ensure DRG audits are appropriately marked for findings and no findings.
Assist in mentoring Coders
Provide updates to training and user manuals
Recommend process changes to improve quality and performance
Communicate with peers and management
Provide root cause analysis on errors
Will perform other duties as assigned

High School Diploma.
Minimum 5 years relevant coding/auditing experience or clinical DRG
Active RN license
RHIT or RHIA certification
CCS certification, CPC certification
Experience with coder tools (TrueCode, 3M, Webstrat)
Sound knowledge of ICD diagnosis/procedure codes, CPT, HCPCS coding guidelines
Ensures appropriate ICD-10 coding and sequencing as it relates to the patient’s medical condition.
Superior auditing and monitoring skills.
Excellent decision making skills and sound judgment.
Thorough understanding of medical terminology and human physiology.
Strong technical knowledge and ability to learn new systems quickly.
Excellent oral/presentation and written communication skills.
Ability to complete tasks efficiently and resolve problems within set timelines.
Excellent client and customer service skills.
Ability to mentor and instruct through audits.
Strong organizational skills and attention to detail.
Demonstrated flexibility and adaptability.
EEO Statement