Vendor Resource Management Team Lead

Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a(an) Vendor Resource Management Team Lead today with Parallon.

Job Summary and Qualifications

As a Vendor Resource Management Coding Lead, you will be responsible for performing concurrent and retrospective quality reviews of vendor ICD-10 Diagnosis and PCS Code/CPT/DRG/abstracting assignments as well as compilation and reporting of results to enhance quality outcomes. You will prepare and provide coder specific education based on audit outcomes and trends. Additionally, you will also assists the VRM Manager with vendor management including monitoring processes and services for improvement, coding quality, trending/analyzing data, creating and presenting education, answering coding questions, and account follow up/resolution. 

This position has a focus on Outpatient.

What you will do in this role: 

• 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 Parallon HIM back office coding staff 
• Collates and presents quality trends and findings to the VRM management team, Vendor teams, and Parallon stakeholders
• 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
• Performs operational reviews of inpatient and/or outpatient records as needed. • 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 

What qualifications you will need: 

• High School diploma required.
• Undergraduate degree in HIM/HIT D preferred.
• Management/Supervisory experience in healthcare related field preferred
• Minimum of 2 years acute care inpatient and/or outpatient coding experience required 
• Coding auditing/monitoring experience strongly preferred
• RHIA, RHIT and/or CCS required 

Benefits

Parallon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The 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

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

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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.

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"The great hospitals will always put the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Vendor Resource Management Team Lead opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!

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.