Vendor Resource Management Coding Manager

This position is incentive eligible.

About the role

The Vendor Resource Management (VRM) Pro-Fee Manager assists in developing and evolving the overall strategy for the Company’s Vendor Resource Management for professional fee and hospital coding operations. This role manages, directs, and coordinates pro-fee coding activities for vendors in collaboration with the Central Coding Unit (CCU). Responsibilities include planning and directing coding workflow, monitoring performance, resolving issues, and ensuring production and quality control efforts meet Service Level Agreements (SLA). The manager also interacts with CCU and VRM leadership to enhance timely claims completion, financial performance, and corporate contribution.

Responsibilities

• Provides direct managerial oversight to vendors and Team Leads in managing pro-fee coding functions, work queues, processes, and responsibilities.
• Ensures complete, accurate, timely, and consistent coding while adhering to published coding guidelines and company policies.
• Coaches and develops team members; resolves dysfunctional or disruptive behavior; promotes teamwork; disciplines and counsels staff as necessary.
• Proactively manages and communicates significant issues in coding, project status, barriers, and successes.
• Selects, evaluates, trains, and provides leadership to reporting staff.
• Continuously reviews and improves processes and services.
• Ensures employee work schedules meet business and customer needs.
• Provides guidance and oversight in retrieving, organizing, and reporting data.
• Facilitates problem-solving and collaboration within functional areas.
• Works closely with the Parallon Central Coding Leadership Team to address issues impacting accurate and timely coding.
• Ensures staff/vendor compliance with documented workflow guidelines for assigning and re-assigning accounts to work queues.
• Facilitates resolution of IT issues related to vendor workflow; submits break-fix requests for reports used by vendors or the VRM team.
• Monitors quarterly quality scores by vendor and specialty; requests action plans from vendors as needed.
• Assists in identifying and implementing process improvements to decrease costs and improve service.
• Performs productivity monitoring and provides timely feedback to vendor and VRM pro-fee team leads.
• Monitors, escalates, and assists in resolving system issues reported by production coders.
• Manages tracking of vendor staff and turnover.
• Oversees all month-end processes, including ensuring month-end volumes are pulled and sent to vendors, turnover and volumes are reported to leadership, and inventory issues are escalated.
• Monitors vendor coders' pended accounts to ensure timely turnaround per contract agreement.
• Provides timely follow-up to customer escalations related to coding quality and process issues.
• Responds to customer requests for action plans to improve coding quality and operational processes.
• Reports issues or trends to the appropriate Parallon Leadership team member or other relevant parties.
• Reviews data quality standards, coding guidelines, company policies, and clinical/medical resources to maintain current coding knowledge and certification.
• Prepares and hosts weekly and/or ad hoc vendor conference calls.
• Coordinates work assignments to achieve operational goals.
• Manages the onboarding process for VRM support staff.
• Establishes and maintains good working relationships with vendors and Parallon stakeholders.
• Coordinates and ensures completion of training and education for VRM team leads and vendor coders.
• Works with multi-disciplinary teams to address issues related to coding and medical record improvement.
• Participates in a weekly rotation of on-call coverage for IT&S issues and facilitates escalations as necessary.
• Ensures safe, ergonomic, and confidentiality-compliant practices in the work environment.
• Maintains advanced knowledge of Hospital Outpatient Facility coding guidelines, regulatory requirements, reimbursement methodologies, and operational workflows.
• Analyzes quality data to identify education opportunities; provides suggestions to the Parallon HIM corporate quality team.
• Provides operational oversight of vendor Outpatient CPART review activities, resolves workflow issues, and escalates concerns to support timely account completion.
• Monitors vendor coders' pended accounts in production and in the HIM CPART review tool to ensure timely turnaround and proper holds per contract agreement.
• Monitors vendor eRequest work queues for Hospital Outpatient Facility coding, assists in resolving issues, and escalates operational concerns.
• Practices and adheres to the "Code of Conduct" philosophy and "Mission and Value Statement."
• Performs other duties as assigned.

Qualifications

• Undergraduate degree required; Bachelor’s degree strongly preferred. Equivalent work experience may substitute education requirements.
• Inpatient/outpatient professional fee coding experience preferred.
• Minimum three years’ experience in a related area preferred, with two of these years in healthcare management.
• Experience managing multi-specialty coders is strongly preferred.
• RHIA, RHIT, and/or CCS/CPC certification required.

Benefits

Parallon offers a total rewards package that supports the health, life, career, and retirement of our colleagues. Available plans and programs include:

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health, and telemedicine services.
• Wellbeing support, including free counseling and referral services.
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage, and leaves of absence.
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support, and financial wellbeing counseling.
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships, and a partnership with Galen College of Nursing.
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection, and consumer discounts.

Note: Eligibility for benefits may vary by location.