Coding Quality Review Coordinator

HCA Healthcare; Nashville (TN); On-site; USD 42,000 - 52,000; Full time

Benefits offered by this job

Comprehensive benefits

Education support

401(k) with match

Employee stock purchase plan

Job summary

HCA Healthcare in Nashville seeks an administrative support specialist for the Coding Quality Review team. You will help manage schedules, coordinate internal and vendor resources, and assist with data entry and reporting for productivity, quality scores, and education.

You will compile information for external audits, prepare review logs, and support education efforts while maintaining timelines and SLA adherence across the CQR workflow.

Qualifications

• High school education preferred.
• 2-year degree or Microsoft Certification preferred.
• Prior administrative support experience; minimum 1-year acute care hospital HIM experience preferred.

Responsibilities

• Maintains schedule of coding quality review resources (internal and vendor).
• Assist with assignment of internal and vendor coding quality review resources.
• Assist with communication of internal and vendor work assignments.
• Assist with compilation of information for external audits.
• Compiles data and presentations for special reviews and projects.

Skills

Administrative support

HIM experience

Communication skills

Education

High school education preferred

2-year degree or Microsoft Certification

Job description

Job Summary and Qualifications

Provides support assistance to the Coding Quality Review team. Assists with coordinating work flow, maintenance of internal schedules, assignments, and communication internally with vendors and/or HSCs and external customers. Assists with entry, tracking and compilation of data for productivity, quality scores, results reporting and education.

What you will do in this role:

• Maintains schedule of coding quality review resource availability, both internally and vendor, according to established need.

• Assist with assignment of internal and vendor coding quality review resources.

• Assist with communication of internal and vendor work assignments.

• Assist with compilation of information for external audits.

• Compiles data and presentations for special reviews, AdHoc requests and projects (e.g. CAC, Cardiac, etc).

• Creates and utilizes review logs for data/updating reporting

• Provides status updates

• Compiles review data

• Assists with processing/data compilation for rebills

• Conducts quality control of internal productivity logs.

• Assists with maintenance of data and production of presentations for CQR MOR.

• Compiles weekly prebill and monthly target reports

• Assists with maintenance of CQR modeler.

• Monitors prebill and 3rd party mailboxes and coordinates work efforts according to established processes and timelines.

• Distributes exception logs to CQRs and monitors for completion.

• Updates prebill log when education plans are received.

• Distributes Internal Audit review results to CQRs and monitors for completion.

• Maintains IA report status document

• Upload Internal Audit initial communication tools, outcomes and accuracy results to manager/admin folder & individual CQRs' folder; create folders, set permission & site administrator

• Process Internal QC rebills, follow up, and create and implement new spreadsheets for Internal QC processes

• Maintain, Validates and Distributes Internal QC Volumes reporting

• Pulls and distributes monthly production reporting

• Uploads review logs to team rooms.

• Monitors prebill workflow for meeting SLA terms.

• Reports on compliance with SLA terms.

• Assists with tracking and coordination of appeals responses and processes.

• Utilized raw data from data analyst and produces meaningful information for customers.

• Creates Excel workbooks.

• Creates PowerPoint presentations.

• Prepares reports as needed

• Create and maintain CQR profile

• Assist with entry, calculation and tracking of productivity and/or quality data as needed

• Assist with tracking education requirements as needed

• Tracks team adherence to CIA and Healthstream requirements

• Workflow queue and/or CQA tool monitoring and follow-up

• Completes all required company education

• Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”

• Maintains knowledge of tools and resources, and associated workflows to include: Computer Assisted Coding (CAC), Electronic Health Records (EHR's), and data capture systems.

• Ownership Revision Creation of Process Documentation Job Aides.

• Contributes support of the Current State Reporting.

• Quarterly review of job duties, reporting, process documentation.

• Other duties as assigned such as monitoring processes within the Remote Workforce Management

• Maintains team roster-updates monthly

• Maintains a separate Outlook calendar of all birthdays and anniversaries and sends birthday and other important event announcements

• Maintains org chart-updates monthly

• Maintains onboarding/orientation checklists-leads updates by seeking input, creating drafts for mgmt. review and input, finalizing, communicating, maintaining in central location

• Maintains CQR shared drive

• Maintains CQR share point sites

• Uploads Internal Audit initial communication tools, outcomes and accuracy results

• Creates folders, sets permissions, and site administrator

• Assists with departure processes

• Summarizes time and activity tracking

• Coordinates the meeting of CQR due dates (reporting, process, workplan updates etc.)

• Maintains random, focus/benchmark and other review calendars

• Schedules and maintains team call agendas

• Schedules and maintains CQR mgmt. call agendas

• Maintains CQR recruitment reporting

• Post 3M Nosology logs to team room

• Review and maintenance, in coordination with others, of the CQR volume reporting list

• Provides supporting documentation for external reviews

Qualifications:

• High school education preferred

• 2-year degree or Microsoft Certification preferred

• Prior administrative support experience preferred. Minimum 1-year acute care hospital HIM experience preferred.

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 (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)

Note: Eligibility for benefits may vary by location.

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.

"There is so much good to do in the world and so many different ways to do it."- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

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.