Virtual Outpatient Coding Quality Reviewer in Nashville, TN at Parallon

Date Posted: 5/4/2018

Job Snapshot

Job Description

The Coding Quality Reviewer(CQR)performs internal quality assessment reviews on Health Information Management Service Center(HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. CQR review outcomes are communicated to the HSC team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the body of the medical record to support code assignments. Outcomes are communicated to the HSC to provide specific coder education and global coding education based on the quality monitoring review findings and trends.  

  • Leads, coordinates and performs all functions of quality reviews (routine, pre-bill, policy driven and incentive plan driven)for inpatient and outpatient coding across multiple HSCs
  • Assists in ensuring HSC coding staff adherence with coding guideline sand policy 
  • Demonstrates and applies expert level knowledge of medical coding practices and concepts
  • Participates on special reviews or projects
  • Maintains or exceeds 95%productivity standards
  • Maintains or exceeds 95¬curacy
  • Meets all educational requirements as stated in current Company 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

  • Undergraduate degree in HIM/HIT preferred
  • Equivalent work experience may substitute degree requirement 

  • Minimum of 3 years' acute care inpatient/outpatient coding experience preferred
  • Minimum of 3 years' coding auditing/monitoring experience strongly preferred

  • RHIA, RHIT and/or CCS preferred