Job Information
HCA Healthcare Coding Operations Education and Appeals Consultant in Nashville, Tennessee
Description
Job Summary and Qualifications
The Coding Operations Education and Appeals Consultant is responsible for assisting in the efficient and effective design, development, and delivery of all coding operations education components and an effective coding appeals review process for the HCA Physician Services Group (PSG). The education program components and the appeals process include coding and Health Information Management (HIM) initiatives. This person serves as a key promoter of Coding Operations and is responsible for setting the tone of Coding Operations as a service organization, continuously seeking to understand, meet, and exceed customer expectations and needs.
The Education Consultant is responsible for assisting in the development of the Quality Assessment program for Central Coding Support and ensuring the education program addresses the findings of Quality Assessment reviews.
The Coding Quality Assessment Program must include internal reviews for PSG Central Coding Support coders to ensure compliance with national coding guidelines, PSG coding policies and the Company coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity.
The Education Consultant works with the PSG Central Coding Support Manager and team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and improve the quality of physician documentation within the body of the medical record to support code assignments. The Education Consultant, in collaboration with the Coding Manager, provides coder specific education and global coding education based on the quality monitoring review findings and trends.
This individual is a contributing member of a cross functional team, which includes division coding staff, Central Coding Support, practice leadership, business owners, project management, the Physician Service Center, IT&S and others as needed. Additionally the Education Consultant provides subject matter expertise related to denial management, including pre-bill claim scrubbing/edits, vendor edit challenges/disputes and post bill processes for efficient claims resolution, including effective appeals for select inventory. This individual will work closely with these various groups to develop and deploy education strategies that are needed to achieve desired results. As a subject matter expert and department representative, this individual consistently demonstrates solid project management skills and behaviors, in addition to continually striving to meet and exceed customer expectations.
Participate in the development of strategic coding and HIM communication and education plans which outline the target audience, training needs, training methods, implementation, and evaluation for PSG.
Participate in the development of coding and HIM content-specific, competency-based, and operational-based communication and education deliverables in conjunction with specific business unit resources and technical experts from the field.
Participate in the delivery of communication and coding and HIM training to various groups, including leadership teams and end-users. Delivery methods may include instructor-led, train-the-trainer, virtual classroom, web-cast, or web-based methodologies.
Inform the Director of Education and the AVP of any significant issues (e.g., education process issues, payer issues, vendor issues, etc.).
Inform the Director of Education and the AVP and cross functional teams regarding unique coding and HIM documentation payer requirements, significant changes and developments.
Assist the Director in the maintenance of coding and HIM training administration records.
Analyze training course evaluations, and recommend appropriate action to incorporate feedback.
Provide coding/HIM education to Central Coding Support staff to assure quality of work.
Identify and implement process improvements to lower costs and improve service to customers
Champion ideas for innovation, knowledge sharing and coding operations workflow in the PSG organization and among peer groups.
Stay abreast of coding/billing regulatory requirements and company compliance policies, ensuring timely staff education.
Understand and communicate nuances of unique coding requirements for major payers such as Medicare, Medicaid, HMO’s, PPO’s, IPA’s, employers, etc.
Demonstrate and share knowledge of medical terminology, International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) coding.
Provide relevant coding guidance for customers and other departments to resolve issues.
Provide subject matter expertise in the development, implementation and monitoring of coding related standard master files, processes, and reporting.
Demonstrate and apply knowledge of principles and practices of Education and Organizational Development.
Assist in translating business reporting requirements to development staff.
Understand Revenue Cycle operations and technologies currently in place.
Moderate travel required (less than 25%), including practice site visits.
Maintain confidentiality with all company and regulated information.
EXPERIENCE:
Minimum of Five years of experience in peripheral vascular coding, cardiac catheterization coding, cardiothoracic procedural coding and vascular graft coding.
In addition, a clinical background and previous chart abstraction experience is preferred.
CERTIFICATION/LICENSE:
- Must be a Certified Coding Specialist (CCS), Certified Coding Specialist - Physician (CCS-P), RHIT (Registered Health Information Technician), RHIA (Registered Health Information Administrator) through AHIMA (American Health Information Management Association) or AAPC's (American Academy of Professional Coders) Certified Professional Coder (CPC®) credential or Certified Professional Coder - Hospital (CPC-H®) or Certified Risk Adjustment Coder (CRC)
Benefits
HCA Healthcare offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
Free counseling services and resources for emotional, physical and financial wellbeing
401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
Employee Stock Purchase Plan with 10% off HCA Healthcare stock
Family support through fertility and family building benefits with Progyny and adoption assistance.
Referral services for child, elder and pet care, home and auto repair, event planning and more
Consumer discounts through Abenity and Consumer Discounts
Retirement readiness, rollover assistance services and preferred banking partnerships
Education assistance (tuition, student loan, certification support, dependent scholarships)
Colleague recognition program
Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.
Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)
Note: Eligibility for benefits may vary by location.
We are seeking a(an) Coding Operations Education and Appeals Consultant for our team to ensure that we continue to provide all patients with high quality, efficient care. Did you get into our industry for these reasons? We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply!
Physician Services Group (https://careers.hcahealthcare.com/pages/physician-services) is skilled in physician employment, practice and urgent care operations. We are experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices and 170+ urgent care centers. We are HCA Healthcare’s graduate medical education leader. We provide direction for over 260 exceptional resident and fellowship programs. We focus on carrying out value-added solutions. These solutions help physicians deliver patient-centered healthcare. We support HCA Healthcare's commitment to the care and improvement of human life.
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
If you find this opportunity compelling, we encourage you to apply for our Coding Operations Education and Appeals Consultant opening. We promptly review all applications. Highly qualified candidates will be directly contacted by a member of our team. We are interviewing apply today!
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.