Vendor Resource Management Coding Team Lead

HCA Healthcare-posted 9 months ago

Full-time • Mid Level

Remote • Nashville, TN

Hospitals

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As a Vendor Resource Management Coding Lead, you will be responsible for performing concurrent and retrospective quality reviews of vendor ICD-10 Diagnosis and PCS Code/CPT/DRG/abstracting assignments as well as compilation and reporting of results to enhance quality outcomes. You will prepare and provide coder specific education based on audit outcomes and trends. Additionally, you will also assist the VRM Manager with vendor management including monitoring processes and services for improvement, coding quality, trending/analyzing data, creating and presenting education, answering coding questions, and account follow up/resolution.

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

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

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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