UW Physicians -
701 Fifth Ave, Ste 700
Seattle , WA , United States
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Revenue Cycle QA Coordinator at UW Physicians

Updated: October 10, 2017
Category: Other - Other

Under limited supervision, the Revenue Cycle QA Coordinator will coordinate, monitor, and perform documentation and coding audits of inpatient and/or outpatient services in all applicable health care settings. Audits will focus on correct assignment of ICD-CM codes as supported by clinical documentation to ensure that UW Physicians is compliant with all regulatory guidelines and internal controls. The Revenue Cycle QA Coordinator will analyze audit results, identify patterns, trends or variations in coding and documentation practices, and make recommendations for improvement. When necessary, this position will recommend action plan(s) to facilitate resolution of discrepancies or problem areas identified during auditing and monitoring activity. This position will serve as a liaison with Practice Advisors, internal coding teams, UW Medicine practitioners or partners, other Revenue Cycle departments, and other departments as needed. Specific skills training and technical instruction may include proper handling of CPT and ICD-10 codes; effective and efficient resolution of coding denials; efficient utilization of Epic Professional Resolute, In Basket and EpicCare modules (the ambulatory electronic medical record, or EMR), Cerner, (the inpatient EMR, also known as “ORCA”), and allied products in support of billing (such as Ingenix Claims Manager), and vendor websites. The Revenue Cycle QA Coordinator is responsible for developing and presenting educational materials for coding and clinical staff.


  • Associate’s degree required; Bachelor's degree preferred. Experience in lieu of degree may be considered.
  • 3 years of experience with physician coding and/or medical billing in a complex multi-specialty environment.
  • 2 years’ experience conducting professional fee billing audits.
  • 1-year experience preparing and presenting compliance or coding training materials to physicians and staff of various sizes.
  • Experience with conducting quality assurance reviews and project management strongly preferred.
  • Completion of certified training curriculum may be considered in lieu of experience.
  • Experience in an academic healthcare environment preferred.
Certifications, License Requirements: 
  • Coding certification (CPC, CCS-P, RHIT, RHIA etc.) required.
Knowledge, Skills & Abilities:  
  • Knowledge of professional billing processes.
  • Applied knowledge of ICD-CM codes, coding conventions and coding guidelines.
  • Working knowledge of medical procedure codes (CPT, HCPCS, ICD-PCS).
  • Knowledge of medical terminology and anatomy/physiology.
  • Experience in developing and providing training to individuals and groups of various sizes.
  • Ability to adapt to changing priorities and different work environments.
  • Ability to work with minimal supervision to prioritize workload and meet quality and production standards.
  • Working knowledge of the critical elements of the auditing process.
  • Knowledge off medical record standards and criteria in the context of risk adjustment data validation.
  • Applied understanding of principles of reimbursement based on risk adjustment models.
  • Demonstrated ability to accurately quantify outcomes and apply analytical problem solving.
  • Ability to maintain confidentiality and handle sensitive information with solid judgment and discretion.
  • Ability to work well with a variety of people and be a team player.
  • Excellent oral and written communication skills, with the ability to convey a positive and professional image, and to interact effectively with diverse personalities and backgrounds.
  • Excellent typing/keyboarding skills with a high degree of accuracy to input data, process information and extract information in various report and presentation formats.
  • Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
  • Strong customer service and relationship management skills.


  • Proficiency with Windows based software and Microsoft Office Suite products in a network environment.
  • Knowledge of Epic EMR and professional billing system required.
  • Perform targeted coding and documentation reviews;
    • Identify deficiencies and report findings and recommendations
    • Ensure that all reviews and audits are based on current ICD-CM coding and documentation guidelines as well as current regulatory requirements
    • Ensure compliance with internal coding guidance, department policies, and other applicable rules and regulations.
  • Identify trends and patterns; compile audit findings and analyze results;
    • Perform root cause analysis to identify system issues that may contribute to coding, documentation, claims or other revenue cycle deficiencies.
    • Prepare a report of all significant audit findings to include, as appropriate or requested, recommendations (e.g., training, oversight, monitoring, process flow changes, documentation and coding education) specific to internal departments, external facilities, and others.
  • Partner with internal departments on regulatory or internal data validation audits;
    • Assist with performing medical record reviews, compiling results, and analyzing findings
    • Communicate audit results to leadership.
    • Assist in developing action plans intended to address and prevent discrepant findings identified during documentation and coding reviews or communicated from other regulatory audits.
  • Develop, compose and maintain instructional and educational materials;
    • Documentation includes, but is not limited to: concepts pertaining to coding, documentation and risk adjustment, desk procedures, work flow charts/diagrams and policies. 
    • Develop and deliver educational and training materials related to results of documentation and coding reviews or pertaining to findings from other regulatory audits.
  • Collaborate and consult with UWP coding teams, Practice Advisors, Revenue Cycle departments, UWP practitioners or partners, and Compliance as appropriate.
  • Perform other duties, as assigned.