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Virtual Coding Quality Review Manager in Nashville at Parallon

Date Posted: 4/25/2019

Job Snapshot

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 Quality Manager is responsible for assisting in the development, evolution and implementation of the overall strategy for the Company’s centralized coding quality operations in the Shared Services Division (SSD).  The manager works with all seven HIM Service Centers (HSCs) to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and improve the quality of physician documentation within the body of the medical record to support code assignments. The Coding Quality Manager  manages, directs and coordinates the centralized HSC’s coding quality monitoring activities.  Responsibilities include management of process and personnel.  The Coding Quality Manager plans, assigns and directs the centralized coding quality monitoring program; actively monitors employee performance and rewards or disciplines accordingly; addresses complaints and resolves problems; and actively oversees and manages production and quality control efforts.   
 
Duties (include but not limited to):

  • Provides direct managerial oversight to Coding Quality Reviewers in the management of coding data quality and education work processes, to include quality pre- and post billing coding reviews and education for each of the seven HSCs and Centralized Coding Resource Management (CCRM)
  • Selects, evaluates, trains, and provides leadership and direction to reporting staff
  • Coaches and helps develop team members; helps resolve dysfunctional behavior and promotes teamwork within functional area(s); disciplines and counsel staff as necessary
  • Performs productivity monitoring and provides timely and consistent feedback to employees and Parallon HIM Director and Assistant Director
  • Responsible for ensuring employee work schedules sufficiently meet the HSCs coding quality monitoring  requirements including reviews for HSC new hires
  • Prepares coding benchmarking and coding quality monitoring reports for the SSD HIM Leadership, HSC Leadership, Market/Division leadership and Group leadership
  • Coordinates work assignments to achieve operational goals
  • Manages HSC customer (HSC COO, Coding Director, Coding Managers) expectations and ensures service is delivered accordingly
  • Provides execution of HIM and Company initiatives and implement quality control processes that support such initiatives (i.e. Computer Assisted Coding, APR-DRGs, etc.).
  • Proactively manages (including corresponding communications and escalation paths) significant issues in coding, status of projects, barriers and successes
  • Assists in the development of strategy, specific goals, objectives, budgets and performance standards for the coding quality monitoring program
  • Assists in identifying and implementing process improvements to decrease costs and improve service for applicable stakeholders
  • Promptly reports issues or trends to the appropriate member of the Parallon HIM Leadership team, or other appropriate party
  • Maintains up-to-date knowledge of regulatory changes impacting coding requirements and ensures coding quality staff are appropriately educated
  • Coordinates training and education for CQR personnel
  • Practices and adheres to the “Code of Conduct” philosophy and “Mission and Value Statement”
  • Other duties as assigned



Job Requirements

Knowledge, Skills & Abilities

  • Coding Technical Skills - extensive regulatory coding (ICD-9-CM, ICD-10-CM, ICD-10-PCS, CPT-4, Modifiers, MS-DRGs, POA assignment and where applicable APR-DRGs and APCs) and associated reimbursement knowledge
  • Leadership - leads individuals and groups toward identified outcomes, setting high performance standards and delivering quality services
  • Critical Thinking - actively and skillfully conceptualizing, applying, analyzing, synthesizing or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning or communication as a guide to belief and action
  • Building and Maintaining Strategic Working Relationships - develops collaborative relationships to facilitate the accomplishment of work goals.  Possesses excellent interpersonal skills in building, negotiating and maintaining crucial relationships
  • Building Trust - interacts with others in a way that gives them confidence in one’s intentions and those of the organization
  • Effective Operational 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 - maintaining effectiveness when experiencing major changes in work tasks or the work environment; able to adapt to change in environment and/or circumstances with a positive outlook; and adjusting effectively to work within new work structures, processes, requirements, or cultures
  • Initiative - independently takes prompt proactive steps towards problem resolution
  • 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
  • Energy - consistently maintaining high levels of activity or productivity; sustaining long working hours when necessary; operates with vigor, effectiveness, and determination over extended periods of time
  • Stress Tolerance - maintaining stable performance under pressure or opposition; handling stress in a manner that is acceptable to others and the organization
  • Planning and Organization - proactively prioritizes initiatives, effectively manages resources and keen ability to multi-task
  • Communication - communicates clearly, proactively and concisely with all key stakeholders.
  • Customer Orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
  • Work Independently - is self-supporting; not needing to rely on others to complete a job
  • Facilitation - ability to facilitate small to large groups of people at various organizational levels for purposes of planning, problem solving, or strategy development
  • 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
  • PC Skills - demonstrates proficiency in Microsoft Office applications and others as required
  • Policies & Procedures - articulates knowledge and understanding of organizational policies, procedures and systems
  • Project Management - assesses work activities and allocates resources appropriately
  • Coach, 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
  • Work Independently - is self-supporting; not needing to rely on others to complete a job




Education

  • Undergraduate degree required.  Bachelor’s degree strongly preferred.


 
Experience

  • Minimum 3 years health care management/leadership experience required
  • Minimum 7 years recent inpatient/outpatient hospital coding experience required
  • Experience managing a large coding team or coding review team strongly preferred


 
Certificate/License

  • RHIA, RHIT and/or CCS required