Vendor Resource Management Profee Coding Manager

Job Summary

The VRM Coding Manager supports the development and evolution of the Company’s Vendor Resource Management coding quality and operations. Key responsibilities include managing processes, personnel, and vendors, and overseeing coding quality, workflow, and team performance.

Qualifications

• Undergraduate degree required. Bachelor’s degree strongly preferred.
• Minimum 3 years health care management/leadership experience required.
• Minimum 3-5 years inpatient/outpatient hospital coding experience strongly preferred.
• Experience managing a large coding pool or coding review pool strongly preferred.
• RHIA, RHIT and/or CCS required.

Responsibilities

• Provides direct managerial oversight to vendors, Coding Leads, Coordinators, and in management of inpatient and outpatient coding functions, quality, workflow, and overall work responsibilities.
• Reviews and ensures proper coverage for team members when short-staffed.
• Hosts weekly calls to discuss and prioritize tasks for the upcoming week.
• Ensures complete, accurate, timely and consistent coding, while adhering to published coding guidelines and Company policies.
• Coaches and supports team members’ development, addresses and resolves dysfunctional behavior and promotes teamwork.
• Proactively manages (including corresponding communications and escalation paths) significant issues in coding, status of projects, barriers and successes.
• Selects, evaluates, trains, and provides leadership and direction to reporting staff.
• Facilitates problem solving and collaboration within functional area(s).
• Monitors vendor coders pended accounts in production as well as in HIM CPART review tool to ensure timely turnaround and proper holds per contract agreement.
• Monitors monthly quality scores by vendor and individual coder; recommends that vendor coding personnel be placed under Quality Improvement Plan (QIP) according to VRM Quality Control Plan, and requests actions plans from the vendors accordingly.
• Responds to customer requests for action plans to improve coding quality and operational process concerns.
• Maintains up-to-date knowledge of regulatory changes impacting coding requirements and ensures VRM staff and vendors are appropriately educated on new standards.
• Monitors and trends computer assisted coding (CAC) reporting and metrics including but not limited to Precision and Recall (P&R) rates, autosuggested codes entry method and actionable edits resolution percentages, ensuring compliance with contract agreements.
• Prepares coding accuracy and productivity reports for the VRM Assistant Director/VRM Directors as needed.
• Participates in Parallon HIM coding process and quality improvement pilots/initiatives, coordinating vendor activities to support these efforts.
• Manages and assists in the Coding Pool Mailbox to ensure timely and accurate feedback to customers and vendor(s).
• Maintains up-to-date knowledge of regulatory changes impacting coding requirements and ensures VRM staff and vendors are appropriately educated on new standards.
• Monitors and trends the vendor escalation log and provides insight to all stakeholders.
• Promptly reports issues or trends to the appropriate member of the Parallon HIMCAB team, HSC Leadership team, or other appropriate party.
• Manages and assists in the Coding Pool Mailbox to ensure timely and accurate feedback to customers and vendor(s).
• Maintains up-to-date knowledge of regulatory changes impacting coding requirements and ensures VRM staff and vendors are appropriately educated on new standards.
• Monitors and trends the vendor escalation log and provides insight to all stakeholders.
• Promptly reports issues or trends to the appropriate member of the Parallon HIMCAB team, HSC Leadership team, or other appropriate party.
• Manages and assists in the Coding Pool Mailbox to ensure timely and accurate feedback to customers and vendor(s).
• Maintains up-to-date knowledge of regulatory changes impacting coding requirements and ensures VRM staff and vendors are appropriately educated on new standards.
• Monitors and trends the vendor escalation log and provides insight to all stakeholders.
• Promptly reports issues or trends to the appropriate member of the Parallon HIMCAB team, HSC Leadership team, or other appropriate party.

Benefits

• 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.
• 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.

About Parallon

Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities. HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

About HCA Healthcare

HCA Healthcare is a leading provider of healthcare services, recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

Equal Opportunity Employer

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.