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Location: Work from home

Coding Quality Reviewer- (Work From Home)

Tennessee-Nashville-Shared Services – Nashville
Schedule: Full-time

Description

The Coding Quality Reviewer 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. Works with the HSC team 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. Works with the HSCF to provide coder specific education and global coding education based on the quality monitoring review findings and trends.

DUTIES INCLUDE BUT ARE NOT LIMITED TO:

Leads, coordinates and performs all functions of quality reviews (routine, new hire pre-bill, policy driven and incentive plan driven) for inpatient and outpatient coding across multiple HSCs

Coordinates coder training and orientation in conjunction with the HSC Coding Manager and SSC Education staff

Assists in ensuring HSC coding staff adherence with coding guidelines and policy

Prepares and presents coding compliance status reports to the HSC COOs and HSC Coding Directors

Assists in identifying accounts for coding quality reviews.

Demonstrates and applies expert level knowledge of medical coding practices and concepts

Assists in strategic planning and budgeting of the coding quality review function

Coordinates activities related to development and education

Maintains or exceeds productivity standards

Maintains or exceeds 95% accuracy

Promptly report issues or trends to the HSC COO and/or HSC Coding Director

Assist in ensuring Coder compliance with HCA Regulatory Coding Compliance educational requirements and policies

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

Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”

Other duties as assigned

Qualifications

KNOWLEDGE, SKILLS & ABILITIES

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

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 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 – 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

Undergraduate degree in HIM/HIT required, RHIA, CCS Certified

Equivalent work experience may substitute degree requirement

EXPERIENCE

Management/Supervisory experience in healthcare related field preferred

Minimum of 5 years acute care inpatient/outpatient coding experience required

Minimum of 3 years coding auditing/monitoring experience strongly preferred

CERTIFICATE/LICENSE
- RHIA, RHIT and/or CCS required.

How To Apply For This Work At Home Job

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