Job Details

Quality Analyst

As a Quality Analyst, you will be responsible for the continuous auditing, evaluation, and quality assurance of behavioral health medical charts, coding compliance, and billing accuracy. You will serve as a subject matter expert, ensuring that our coding team maintains the highest levels of precision while adhering to strict HIPAA regulations and client-specific guidelines.

The ideal candidate possesses exceptional deductive reasoning, a sharp eye for detail, and the communication skills necessary to provide constructive feedback and coaching to frontline coding teammates.

Core Responsibilities

• Quality Auditing: Conduct routine, objective quality reviews and audits of behavioral health coding, documentation, and billing submissions to ensure compliance with official coding guidelines.
• Error Analysis & Calibration: Identify trends, systemic issues, and individual coding errors. Use the AAPC CPT E/M MDM Leveling Grid/E/M Calculator to validate complex evaluation and management leveling.
• Feedback & Coaching: Deliver clear, actionable, and supportive feedback to Coding Teammates to improve accuracy and productivity.
• Process Improvement: Partner with leadership (including coordination with stakeholders like Julienne Smith) to update auditing grids, identify training gaps, and streamline workflows.
• Compliance Enforcement: Safeguard patient data by ensuring all processed charts strictly adhere to HIPAA and internal security standards.

Experience & Certifications

• CPC Certification: Active CPC (Certified Professional Coder) credential required. Additional auditing credentials (e.g., CPMA) are a strong plus.
• Coding & Auditing Experience: Minimum 1 years of Medical Billing and Coding experience, with at least 1 year specifically in a Quality Assurance, Auditing, or Senior Coder role.
• Specialty Knowledge: Hands-on experience with Behavioral Health/Mental Health coding and billing highly preferred.
• Tool Proficiency: Expert-level mastery of CPT, ICD-10-CM, and E/M leveling tools.

Core Skills & Traits

• Analytical Mindset: Exceptional deductive reasoning skills and an uncompromising attention to detail.
• Technical Articulation: Ability to clearly explain complex coding rationale and compliance rules to both technical peers and non-technical stakeholders.
• Communication Style: Excellent written and verbal communication; capable of coaching others constructively without sounding rigid.
• Growth Mindset: Curious, adaptable, organized, and highly efficient in a self-started, remote environment.