Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded and your abilities challenged. It is a place where your diversity — of culture, thinking, learning and leading — is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research.
Provides leadership in developing and maintaining an ongoing training plan to address the needs of each targeted population of coders, clinical documentation specialists, and providers related to clinical documentation and coding improvement. Updates the training plan regularly to reflect identified gaps or performance concerns. Develops and delivers educational programs and presentations. Serves as a resource to coders, staff, auditors, department personnel, case managers and clinicians. Serves as the primary professional in the dissemination of coding requirements and AHA Coding Clinic updates to stakeholders.
Enhances VUMC's financial outcomes by facilitating strategies for monitoring third-party payor audits and providing expert coder responses to denials and ensuring accurate and optimum payor reimbursement to VUMC. Also, works with Chief of Medical Staff Quality, PSI and Mortality Committees as the clinical coding expert for VUMC's O/E mortality reviews.
The ideal candidate will possess sufficient knowledge, training, and experience to independently deliver healthcare team education services. Promotes critical thinking and problem solving. Able to train and educate by example, technical instruction, and leadership.
Develops, secures approval and updates the training plan.
Regularly participates in the development of education and training on documentation for accurate coding practices and compliance issues.
Prepare and deliver clinical documentation standards and best practices training for new providers.
Ensure all training materials are recorded, documented and archived.
Conduct training on AHA coding guidelines, state and federal coding changes.
Identifies trends in clinical documentation and code assignments, evaluates the causes and takes appropriate steps to effect favorable problem resolution or provide explanation of any variables.
The responsibilities listed are a general overview of the position and additional duties may be assigned.
Coordinates, oversees and collaborates with medical center departments to develop and implement improvements to processes.
Formulates timely, relevant educational programs to ensure coding proficiency, compliance with ICD-10-CM updates and Centers for Medicare & Medicare regulatory updates.
Serves as an expert resource for VUMC's prospective payment coding setting, PSI and Vizient risk factor assignment. Educates physicians and other health care professionals in MS-DRG / APR/DRG / APC reimbursements / methodologies.
Coordinates responses to external audits to ensure accuracy with services provided. Designs and implements improvement to communication and processes.
Responds to external payor coding audits ensuring payor reimbursement accuracy and adherence to coding rules. Implements timely corrective action to prevent payor payment denials to VUMC.
Interprets coding guidelines and applicable regulations pertaining to hospital reimbursements as published in American Hospital Association's Coding Clinic, Federal Register, and Medicare Bulletins.
Compares coding and reimbursement profiles with national and regional benchmarking data and identifies areas requiring further action.
Conducts trend analysis to identify coding patterns and variations.
Provides high level strategic oversight for coding quality projects across the medical center.
Oversees VUMC's O/E Coding Mortality reviews and coordinates physician involvement.
Provides oversight to Denials Management
Reviews denial letters, and formulates expert coder responses to denials.
RN or HIM credential is required (on of the following: RHIT, RHIA, CCS).
Certified AHIMA ICD-10 trainer, required.
CDIP or CCDS certification preferred.
VUMC Recent Accomplishments:
Because we are committed to providing the best in patient care, education and research, we are proud of our recent accomplishments:
US News & World Report: #1 Hospital in Tennessee, #1 Health Care Provider in Nashville, #1 Audiology ( Bill Wilkerson Center ), 12 adult and 10 pediatric clinical specialties ranked among the nation's best, #15 Education and Training
Truven Health Analytics: among the top 50 cardiovascular hospitals in the U.S.
Becker's Hospital Review: one of the "100 Greatest Hospitals in America"
The Leapfrog Group: grade "A" in Hospital Safety Score
National Institutes of Health: among the top 10 grant awardees for medical research in the US
Magnet Recognition Program: Vanderbilt nurses are the only group honored in Middle Tennessee
Nashville Business Journal: Middle Tennessee's healthiest employer
American Hospital Association: among the 100 "Most Wired" medical systems in the US
Vanderbilt University Medical Center is home to Vanderbilt University Hospital, The Monroe Carell Jr. Children’s Hospital at Vanderbilt, the Vanderbilt Psychiatric Hospital and the Vanderbilt Stallworth Rehabilitation Hospital. These hospitals experienced more than 61,000 inpatient admissions during fiscal year 2015. Vanderbilt’s adult and pediatric clinics treated nearly 2 million patients during this same period.
Vanderbilt University Hospital and the Monroe Carell Jr. Children’s Hospital at Vanderbilt are recognized again this year by U.S. News & World Report’s Best Hospitals as among the nation’s best with 18 nationally ranked specialties.
Vanderbilt University Medical Center is world renowned because of the innovation, work ethic and collegiality of its employees. From our health care advances to our compassionate care, Vanderbilt owes its accomplishments and reputation to staff and faculty who bring skill and drive and innovation to the medical center day after day. World-leading academic departments and comprehensive centers of excellence pursue scientific discoveries and transformational educational and clinical advances across the entire spectrum of health and disea...se.
As the largest employer in middle Tennessee, we welcome those who are interested in ongoing development in a caring, culturally sensitive and professional atmosphere. Most of us spend so much of our lives at work, we want to be part of maintaining a workplace in which people support one another and encourage reaching for excellence. Many high-achieving employees stay at Vanderbilt because of the professional growth they experience and because of their appreciation of Vanderbilt’s benefits, public events and discussions, athletic opportunities, beautiful setting and, above all, sense of community and purpose.
Vanderbilt and its employees share a set of mutual expectations that have been created with productivity, legality, fairness and safety always in mind. We believe that our investment in training and compensating employees multiplies in value when we enable individuals to deliver their best performance for the benefit of us all.