Vendor Resource Inpatient Coding

Job Summary

In this role you will:

• 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 HSCs or corporate HIM.
• Collates and presents quality trends and findings to the VRM management team, Vendor teams
• HSC coding leadership and HIM Leadership
• 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
• 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
• Monitors and maintains the communication logs between the HSCs and the coding vendors, including but not limited to the mailbox escalations, CIMRR logs and VRM vendor error logs

Qualifications

• Undergraduate degree in HIM/HIT preferred.
• Management/Supervisory experience in healthcare related field required
• Minimum of 2 years acute care inpatient and/or outpatient coding experience required
• Coding auditing/monitoring experience strongly preferred
• Associate Degree
• Certified Coding Specialist (CCS), or Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT)

60% Auditing

Must have acute care, inpatient, DRG experience

Must have experience in EPIC, CHC, 3M

Must have EXCEL

Must have good presentation skills (be able to communicate audit results and quality outcomes

Must be able to predict trending and predicting quality outcomes

Analytics Exp preferred

WILL NOT ACCEPT CANDIDATES RESIDING IN CALIFORNIA OR COLORADO

• CANDIDATES MUST LIVE MIN 60 MILES WITHIN A HCA FACILITY

Job Type: Full-time

Salary: $30.00 - $38.00 per hour

Benefits:

• 401(k)
• Health insurance
• Life insurance

Schedule:

• Monday to Friday

Work setting:

• Remote

Experience:

• ICD-10: 2 years (Required)
• Acute care: 3 years (Required)

License/Certification:

• Certified Coding Specialist (Required)

Work Location: Remote