HCA, Hospital Corporation of America Codinq Qual Rvw OVH II WFH in Nashville, Tennessee
Parallon believes that organizations that continuously learn and improve will thrive. That's why, after more than a decade, Parallon remains dedicated to helping hospitals and hospital systems operate knowledgeably, intelligently, effectively and efficiently in the rapidly evolving healthcare marketplace, today and in the future.
As one of the healthcare industry's leading providers of business and operational services, Parallon is uniquely equipped to provide a broad spectrum of customized services in the areas of revenue cycle, purchasing, supply chain, technology, workforce management and consulting.
Parallon's purpose is simple. We serve and enable those who care for and improve human life in their communities.
TheCodingQualityReviewer(CQR)performsinternalqualityassessmentreviewsonHealthInformationManagementServiceCenter(HSC)coderstoensurecompliance withnationalcodingguidelines,theHSCcodingpoliciesandtheCompanycodingpoliciesforcomplete,accurateandconsistentcodingwhichresultinappropriatereimbursementanddataintegrity. CQR review outcomes are communicated to the HSC team to improvetheaccuracy,integrityandqualityofpatientdata,toensure minimalvariationincodingpracticesandtoimprovethequalityofphysiciandocumentationwithinthebodyofthemedicalrecord tosupport codeassignments. Outcomes are communicated to the HSC to provide specific coder education and global coding education based on the quality monitoring review findings and trends.
DUTIES INCLUDE BUT ARE NOT LIMITED TO: * Leads,coordinatesandperformsallfunctionsofqualityreviews(routine, pre-bill,policydrivenandincentiveplandriven)forinpatientandoutpatientcodingacrossmultipleHSCs * AssistsinensuringHSCcodingstaffadherencewithcodingguidelinesandpolicy * Demonstratesandappliesexpertlevelknowledgeofmedicalcodingpracticesandconcepts * Participates on special reviews or projects * Maintainsorexceeds 95%productivitystandards * Maintainsorexceeds95%accuracy * AssistsinensuringCodercompliancewithHCARegulatoryCodingComplianceeducationalrequirementsandpolicies * Reviewsallofficialdataqualitystandards,codingguidelines,Companypoliciesandprocedures,andclinical/medicalresourcestoassurecodingknowledgeandskillsremaincurrent * Practicesandadherestothe“CodeofConduct”philosophyand“MissionandValueStatement” * Otherdutiesasassigned
QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
KNOWLEDGE, SKILLS, & ABILITIES- This position requires the following minimum requirements: * Coding Technical/Professional Knowledge and Skills - extensive regulatory coding, (ICD-10-CM, ICD-10- PCS, CPT-4, Modifiers, MS-DRGs, POA assignment and where applicable APR-DRGs and APCs) and associated reimbursement knowledge * Effective Decision Making - relating and comparing; securing relevant information and identifying key issues; committing to an action after developing alternative courses of action that take into consideration resources, constraints, and organizational values * Adaptability to major changes in work responsibilities or environment; adjusting effectively to work within new work structures, processes, requirements, or cultures * Initiative - independently takes prompt proactive steps toward problem resolution * Contributing to Team Success by actively participating as a member of the team to move the team toward the completion of goals * Work Standards –setting high standards of performance for self and others; assuming responsibility and accountability for successfully completing assignments or tasks; self-imposing standards of excellence rather than having standards imposed * Organization - establishing courses of action to ensure that work is completed efficiently; proactively prioritizes assignments and keen ability to multi-task * Communication - communicates clearly, proactively and concisely with all key stakeholders Leadership - leads individuals and groups toward desired outcomes, setting high performance standards and delivering leading quality services * Customer Orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations * Policies & Procedures - articulates knowledge and understanding of organizational policies, procedures and systems * PC Skills - demonstrates proficiency in Microsoft Office applications and others as required Quality Orientation - accomplishing tasks by considering all areas involved, no matter how small; showing concern for all aspects of the job; accurately checking processes and tasks; being watchful over a period of time * Work Independently in a Remote Environment - is self-supporting; not needing to rely on others to complete a job * Building and Maintaining Strategic Working Relationships - develops collaborative relationships to facilitate the accomplishment of work goals. Possesses good interpersonal skills in building, negotiating, and maintaining crucial relationships * Managing Conflict - dealing effectively with others in an antagonistic situation; using appropriate interpersonal styles and methods to reduce tension or conflict between two or more people * Mentor and Educate - provides timely guidance and feedback to help strengthen the knowledge/skill set of others to accomplish a task or solve a problem
EDUCATION and/or EXPERIENCE * ICD-10 training or certification required. Applicants should attach proof of training/education when completing application. * * UndergraduatedegreeinHIM/HIT preferred * Equivalentworkexperiencemaysubstitutedegreerequirement * *Minimum of 3 years' acute care inpatient/outpatient coding experience preferred * Minimum of 3 years' coding auditing/monitoring experience strongly preferred CERTIFICATE/LICENSURE
- **RHIA,RHITand/orCCS preferred
Title: Codinq Qual Rvw OVH II WFH
Location: Tennessee-Nashville-HSC - Overhead
Requisition ID: 03416-00006