Inpatient Lead Coder (Remote)
Job Description
Job 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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