Remote Utilization Review Rn Jobs in Chattanooga, TN

Erlanger Health hires employees for telecommuting/remote positions in the following states:
AL, AZ, GA, FL, IN, KY, LA, MD, MI, MS, MO, NC, NV, OH, PA, SC, TN, TX, VA, WI, WY
Job Summary:
This position is responsible for the overall direction and daily operations of the coding functions for the departments within Erlanger that impact the coding processes of inpatient facility operations. This position is responsible for the day-to-day management of coding staff to ensure timely coding/entry of ICD-10-CM and ICD-10 PCS codes. This position oversees the coding and workflows of daily unbilled accounts through work queues to ensure timely coding/billing and compliance. Development and maintenance of hospital coding policies and procedures, implementation of changes as appropriate, and providing relevant feedback to coding staff is included within the scope of this position. The incumbent directs education programs to coding staff that support regulatory compliance, and clinical documentation improvement for accurate and complete coding, to substantiate reimbursement.
Responsibilities Include:
- Hires, trains, on boards and oversees auditors and coders.
- Perform new employee orientation.
- Identifies opportunities to improve coding performance and documentation.
- Helps create and maintain internal coding policies and procedures.
- Provide coding and audit training to new and existing staff.
- Oversees periodic quality assurance audits on coding and audit team.
- Reviews or prepares reports on coders and auditors productivity and quality.
- Monitors staff workloads. Setting coding turnaround time and productivity expectations
- Serves as an educator for the audit and other healthcare professionals/departments in the use of coding guidelines and proper documentation requirements as it relates to data quality management and reimbursement.
- Review and approve timesheets for coding & audit staff
- Prepare and conduct annual evaluations of team performance, as directed by HR
- Comply with policies regarding the use and disclosure of protected health information which includes accessing and using protected health information
- Maintains up-to-date knowledge of regulatory changes impacting coding requirements and ensures audit staff are appropriately educated.
- Other duties as assigned
Education:
Required: AS degree in Health Information Management Administration or Health Information Technician from an accredited program.
Preferred: BS degree in Health Information Management.
Experience:
Required: Requires five years in an acute care setting. Three or more years in a management position responsible for general areas of department workflow with specific focus on coding & reimbursement processes. This individual must be able to have broad scope of HIM department with understanding of complete workflow and its relationship for chart completion and reimbursement. Excellent communication skills, leadership abilities that promote growth and development of employees; critical thinking and decision-making skills; ability to interact with all levels of the organization; and must demonstrate resourcefulness and adaptability. Knowledge of coding and classifications systems applicable to inpatient accounts and knowledge of reimbursement methodologies applicable to inpatient accounts.
Preferred: Level 1 Academic Medical center experience
Position Requirement(s): License/Certification/Registration
Required: Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS)
Preferred: Registered Health Information Administrator (RHIA)
Department Position Summary:
Responsible for high quality and efficient management of inpatient accounts for all Erlanger Health facilities. Manages overall activities of personnel (in-house and remote coders) to ensure timeliness and compliance with CMS, OIG, and Erlanger account receivable goals.
The leader will be responsible for continuous performance improvement in all Fundamentals and for reporting regularly on the opportunities and risks they have identified, the strategies and initiatives they are implementing and the performance, compared with budget, benchmarks and prior performance that they are achieving as a result.
Performance is expected to be measured empirically and compared with organizations of similar size, scope and complexity and such performance is expected to be better than peer organizations and functions.
Accumulation of data and the development of findings, conclusions and recommendations are a significant expectation of this position along with the development and leadership of initiatives to improve the performance of the organization in all areas of Strategy and Fundamentals.