Virtual Coding Pool Team Lead in Nashville, TN at Parallon

Date Posted: 3/21/2018

Job Snapshot

  • Employee Type:
  • Location:
    552 Metroplex Drive
    Nashville, TN
  • Job Type:
  • Experience:
    At least 2 year(s)
  • Date Posted:

Job Description

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 CCRM Manager with vendor management including monitoring work queues to ensure turnaround time Service Level Agreements (SLA’s) met, answering coding questions and account follow up/resolution.

Duties (included but not limited to):

  • Assists CCRM Manager in the review and improvement of processes and services
  • Prepares and presents  coder education and orientation in conjunction with CCRM Manager
  • Assists CCRM Manager in capturing and trending quality data
  • Assists CCRM Manager in ensuring global vendor staff adhere with coding guidelines and policies
  • Demonstrates and applies expert level knowledge of medical coding practices and concepts; assists in ensuring global vendor coders adherence with coding guidelines and policy
  • Assists in managing global 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; Where applicable, validates 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 global 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
  • Monitors coding queues to ensure timely processing of records
  • Monitors and maintains the error communication log between the HSCs and the coding vendors
  • Communicates as appropriate with the global vendor staff and HSCs to ensure proper account resolution
  • Maintains or exceeds 95% coding review accuracy
  • Maintains or exceeds 95% productivity standards
  • 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 global coding vendors


Job Requirements

Knowledge, Skills & Abilities

  • Coding Technical skills ‐ extensive regulatory coding (ICD‐10‐CM/PCS, MS‐DRGs, POA Assignment, APR-DRG,  and CPT/HCPCS,  and where applicable facility E/M level and injection/infusion procedure coding) 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
  • 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