QA I Coding Operations

QA I Coding Operations Job Locations US-Remote ID 2026-21854 Category Coding Position Type Part-Time Overview The QA I, is an integral member of the Risk Adjustment Coding Team. The QA position monitors and reports on the accuracy of all coding performed by Cotiviti coders and/or third party partner coders. This position provides direct coaching and feedback to coders. The QA I conducts QA and audit reviews, supports remediation for risk adjustment coding services, and ensures compliance with quality standards. Responsibilities Provides Quality Assurance feedback by working as a liaison between Coder I, Coder II and the Team Lead to ensure coding is complete and accurate. Reviews a defined percentage of the Coder I and Coder II work to ensure quality standards are met and maintained. * Completes chart or encounter review for proper HCC-mapped diagnosis coding from various chart types (physician, facility, non-facility). * Completes chart or encounter review for proper HCC-mapped diagnosis coding performed prospectively, concurrent, or retrospective. * Ensures that all coding performed follows client specific or industry standard coding guidelines and reflects an accurate and complete representation of the documentation within the medical record. * Professionally communicates findings, errors, and any suggestions to all staff to facilitate ongoing communications and efficient department operations. * Completes internal audits as necessary to support quality accuracy. * Reviews internal system reports on the quality of work for all assigned coding staff. These reports are reviewed daily, weekly, monthly, quarterly, and yearly as needed. * Communicate quality issues and trends to the coders, QA II, team lead, and manager. * Recommend additional training based on the results of the quality audit for those Coder I and Coder II as needed. * Develop an action plan in collaboration with the Team Lead and Manager as needed regarding improvement in the quality of work for a Coder I or II and reports progress to the Team Lead. * Regular interaction with other Cotiviti staff, such as training and quality assurance to facilitate clarification and/or training on coding results. * Completes chart or encounter review for proper HCC mapped diagnosis coding from various chart types (physician, Facility, non - Facility). Ensures that the highest level of HCC mapped diagnosis code was utilized in each date of service reviewed and documentation of findings in company data storage program. Professionally communicates finds, errors, and any suggestions to all staff in order to facilitate on-going communications and efficient department operations. * Completes internal audits as necessary to support quality accuracy. * Responds to questions via the 'Questions Queue' for individual coders. * Reviews internal system reports on quality of work for all assigned Clinical Coder Specialists. These reports are reviewed daily, weekly, monthly, quarterly and yearly as needed. * Communicate quality issues and trends to the Team lead, Coding Manager and Training Manager. * Recommend additional training based on results of the quality audit for those Coder I and Coder II where they fall behind the 95% accuracy rate. * Develop an action plan in collaboration with the Team Lead and Manager as needed with regard to improvement in the quality of work for a Coder I or II and reports progress to the Team Lead. * Regular interaction with other Cotiviti staff, such as training and * Utilize Cotiviti training tool s and coding library for questions. * Completes all responsibilities as outlined on annual Performance Plan. * Completes all special projects and other duties as assigned. * Must be able... For full info follow application link. Equal Opportunity Employer/Protected Vete ans/Individuals with Disabilities