Job Description
About the position
- Responsibilities
- Actively participates in the review and improvement of processes and services
- Responsible for analyzing weekly/monthly quality data to identify trends by vendor and coder/auditor that need to be addressed
- Prepares and presents coder education as needed based on trends and/or problematic areas identified by Parallon HIM back office coding staff
- Collates and presents quality trends and findings to the VRM management team, Vendor teams, and Parallon stakeholders
- Monitors and ensures vendor staff adhere with coding guidelines and policies
- Demonstrates and applies expert level knowledge of medical coding practices and concepts; assists in ensuring vendor coders adherence with coding guidelines and policy
- Assists in managing coding vendor daily workflow (e.g., work queues,/worklists, turnaround times, quality)
- Performs quality reviews of inpatient and/or outpatient records as needed (including concurrent coding); where applicable, validates physician queries, ICD-10-CM, ICD-10-PCS, CPT/HCPCS level II Codes as well as facility E/M levels and injection/infusion procedure codes assigned by vendor coders
- Performs operational reviews of inpatient and/or outpatient records as needed
- Validates accuracy of codes assigned by CAC (Computer Assisted Coding) tool; assists in monitoring coders CAC adoption behavior; assists in identifying precision and recall improvement opportunities
- Monitors and assists the vendors in the monthly random, focus, prebill review, and Ad Hoc quality review process
- Submits and reviews coding appeals as appropriate
- Requirements
- High School diploma required
- Undergraduate degree in HIM/HIT preferred
- Management/Supervisory experience in healthcare related field preferred
- Minimum of 2 years acute care inpatient and/or outpatient coding experience required
- Coding auditing/monitoring experience strongly preferred
- RHIA, RHIT and/or CCS required
- Benefits
- Comprehensive medical coverage that covers many common services at no cost or for a low copay
- Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans
- Free counseling services and resources for emotional, physical and financial wellbeing
- 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
- Employee Stock Purchase Plan with 10% off HCA Healthcare stock
- Family support through fertility and family building benefits with Progyny and adoption assistance
- Referral services for child, elder and pet care, home and auto repair, event planning and more
- Consumer discounts through Abenity and Consumer Discounts
- Retirement readiness, rollover assistance services and preferred banking partnerships
- Education assistance (tuition, student loan, certification support, dependent scholarships)
- Colleague recognition program
- Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
- Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income
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