Inpatient Lead Coder

4 weeks ago


Nashville, United States All Med Search Full time
Job DescriptionJob Description
  • Actively participates in the review and improvement of processes and services
  • Responsible for analyzing weekly/monthly quality data to identify trends by vendor and coder/auditor that need to be addressed
  • Prepares and presents coder education as needed based on trends and/or problematic areas identified by HSCs or corporate HIM.
  • Collates and presents quality trends and findings to the VRM management team, Vendor teams
  • HSC coding leadership and HIM Leadership
  • Monitors and ensures vendor staff adhere with coding guidelines and policies
  • Demonstrates and applies expert level knowledge of medical coding practices and concepts; assists in ensuring vendor coders adherence with coding guidelines and policy
  • Assists in managing coding vendor daily workflow (e.g., work queues,/worklists, turnaround times, quality)
  • Performs quality reviews of inpatient and/or outpatient records as needed (including concurrent coding); where applicable, validates physician queries, 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 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
  • Submits and reviews coding appeals as appropriate
  • Monitors and maintains the communication logs between the HSCs and the coding vendors, including but not limited to the mailbox escalations, CIMRR logs and VRM vendor error logs

Qualifications

  • Undergraduate degree in HIM/HIT preferred.
  • Management/Supervisory experience in healthcare related field required
  • Minimum of 2 years acute care inpatient and/or outpatient coding experience required
  • Coding auditing/monitoring experience strongly preferred
  • Associate Degree
  • Certified Coding Specialist (CCS),or Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT)








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