MIPS Reporting Coordinator

Medcare MSO, a leading USA-based Healthcare IT company in Pakistan with over 1,000 employees, is seeking a detail-oriented MIPS Reporting Coordinator to join its team in Lahore. This role involves supporting both the organization and its clients with Merit-Based Incentive Payment System (MIPS) reporting, ensuring billing accuracy, and maintaining regulatory compliance. The ideal candidate will collaborate closely with coding and billing teams, manage client requirements, and help optimize MIPS strategies using state-of-the-art technology tools. This is an on-site position with shift timings from 10:00 am to 7:00 pm.

Key Responsibilities

Requirement Gathering: Serve as the primary liaison for clients to collect detailed requirements, understand clinical workflows, and define tailored MIPS reporting strategies.

MIPS Coding Definition: Define, map, and maintain relevant MIPS quality codes, including CPT Category II codes, G-codes, and ICD-10 crosswalks, to ensure accurate measure capture.

Data Validation & Auditing: Conduct regular audits of billed claims to verify alignment between MIPS billing codes, clinical documentation, and CMS specifications.

Program Coordination: Support and coordinate MIPS reporting activities in compliance with CMS Quality Payment Program (QPP) guidelines.

Portal & Account Management: Manage HARP (HCQIS Access Roles and Profile) account access, client registries, and CMS QPP Portal permissions to facilitate smooth reporting processes.

EHR Integration: Collaborate with EHR implementation teams to configure, validate, and optimize quality reporting measures and documentation templates.

Performance Monitoring: Monitor data quality, identify documentation gaps, and recommend workflow improvements to enhance MIPS score optimization.

Compliance: Stay updated on annual CMS MIPS changes, threshold updates, and reporting rules, effectively communicating these updates to internal teams and clients.

Required Qualifications

Education: Bachelor’s degree in a medical discipline, Healthcare Administration, Health Information Management (HIM), Finance, or a related field.

Experience:
- 2 to 5 years of experience in MIPS consulting, healthcare quality reporting, or CMS Quality Payment Program (QPP) coordination.
- Proven background in medical coding and billing environments, especially with CPT Category II codes and quality measure claim-mapping.
- Experience in client-facing roles involving gathering technical and clinical requirements and translating them into actionable reporting plans.
- Familiarity with various EHR/EMR platforms and registry-based reporting portals.

Knowledge & Skills:
- Strong expertise in MIPS billing codes, quality measure specifications, and claims-based reporting.
- Excellent client communication skills with the ability to lead requirement-gathering sessions.
- Deep understanding of the billing lifecycle and its impact on MIPS performance scoring.
- Analytical skills to audit billing data and identify missed MIPS opportunities.
- Knowledge of CMS compliance standards, HIPAA regulations, and value-based care frameworks.
- Proficiency in data analysis tools, particularly advanced Excel.

This role offers the opportunity to work with a dynamic team at one of the largest healthcare IT firms in Pakistan, contributing to impactful healthcare quality initiatives aligned with CMS standards.