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Virtual Coding Pool Team Lead in Nashville at Parallon

Date Posted: 4/19/2019

Job Snapshot

  • Employee Type:
  • Location:
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  • Experience:
    At least 2 year(s)
  • Date Posted:

Job Description

Parallon believes that organizations that continuously learn and improve will thrive. That’s why, after more than a decade, we remain 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 revenue cycle services.

The Coding Lead performs quality reviews of vendor code/DRG/abstracting assignments as well as compilation and reporting of results to enhance quality outcomes.  The lead prepares and provides coder specific education based on audit outcomes and trends.  The lead also assists the Coding Pool manager with vendor management including monitoring work queues to ensure turnaround time Service Level Agreements (SLAs) met, answering coding questions and account follow up/resolution. 

Duties (included but not limited to):
  • Assists the CCRM Manager in the review and improvement of processes and services 
  • Prepares and presents  coder education  and orientation in conjunction with CCRM Manager 
  • Assists the CCRM Manager in capturing and trending quality data  
  • Assists CCRM Manager in ensuring International vendor staff adhere with coding guidelines and policies 
  • Demonstrates and applies expert level knowledge of medical coding practices and concepts
  • Assists in managing the international coding vendor daily workflow (e.g., monitoring work volumes, work queues, turnaround times, quality)
  • Performs quality reviews of inpatient and/or outpatient records as needed 
  • Monitors and assists the vendors in the monthly random and quarterly benchmark quality audit process
  • Submits review appeals as appropriate
  • Monitors coding queues daily to ensure timely processing of records 
  • Monitors and maintains the error communication log between the Health Information Management Service Centers (HSCs) and the coding vendors
  • Communicates as appropriate with the International vendor staff and HSCs to ensure proper account resolution
  • Assists with maintenance of staff lists
  • Assists with preparation and maintenance of Quality review logs
  • Answers coding questions from vendors 
  • Prepares meeting minutes as requested 
  • Maintains or exceeds 95% codingreview accuracy 
  • Initiates quality reviews of physician queries in compliance with Company and HSC policy where appropriate
  • Utilizes complete medical record documentation when performing coding quality reviews
  • Maintains good working relationships with the international coding vendors 
  • Meets all educational requirements as stated in current Company and HSC policy
  • Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current
  • Practices and adheres to the “Code of Conduct” philosophy and “Mission and Value Statement”   
  • Other duties as assigned

Job Requirements

  • Coding Technical skills ‐ extensive regulatory coding (ICD‐9‐CM, CPT‐4, MS‐DRGs, POA Assignment and where applicable APR‐DRGs and PPCs) and associated reimbursement knowledge 
  • Case Mix Index Analytical skills ‐ ability to analyze trends in CMI and determine root cause and address as appropriate 
  • 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 
  • Initiative ‐ independently takes prompt proactive steps toward problem resolution
  • Organization ‐ establishing courses of action to ensure that work is completed efficiently; proactively prioritizes assignments and keen ability to multi‐task 
  • Communication – communicates professionally, clearly, proactively, and concisely with all key stakeholders, both individually and in group settings.  
  • Leadership ‐ guides individuals and groups toward desired outcomes 
  • 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 organization policies, procedures and systems
  • PC Skills – skilled in all Microsoft Office applications.
  • 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 – 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

  • Undergraduate degree in HIM/HIT required or equivalent work experience

  • Management/Supervisory experience in healthcare related field preferred 
  • Minimum of 2 years' acute care inpatient/outpatient coding experience required  
  • Coding auditing/monitoring experience strongly preferred   

  • RHIA, RHIT and/or CCS required