Easter Seals Jobs

Discover Vanderbilt University Medical Center: Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of diverse 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. Vanderbilt Health recognizes that diversity is essential for excellence and innovation. We are committed to an inclusive environment where everyone has the chance to thrive and 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.

Organization:

CDACE - Audit

Job Summary:

JOB SUMMARY

Provides leadership in sharing current and relevant coding subject matter expertise with staff. Performs audits of inpatient and/or outpatient coding. Understands and applies quality standards to all aspects of the documentation integrity program. Identifies areas for strategic audits, coding education and improvement. Supports denials management process and other initiatives.

.

INPATIENT CODING EXPERIENCE REQUIRED / Auditor Background Preferred

KEY RESPONSIBILITIES

• Reviews documentation to ensure assigned codes are supported. Recognizes documentation clarification opportunities and works with team to secure additional documentation.

• Assigns codes that most appropriately reflect documentation of the patient stay, severity of illness, risk of mortality, and resources utilized during the patient encounter.

• Writes explanations to support or rebut coding recommendations and appeals for denied or downcoded encounters.

• Participates in accurate data collection, analysis, evaluation, problem solving and recommendations of process improvements.

• Performs pre and post-bill reviews, qualitative review and prospective third party payor reviews based on identified issues. Performs prebill reviews and education for new coders.

• Performs data analysis of the audit program ,findings, and other source data, to identify trends and patterns. Creates detailed reports based on audit findings and facilitates change processes.

• The responsibilities listed are a general overview of the position and additional duties may be assigned.

TECHNICAL CAPABILITIES

• Peer Leadership (Intermediate): The ability to show leadership and influence people of equal rank in an effort to accomplish team goals.

• Medical Coding (Expert): The transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes.

• Critical Thinking (Advanced): The objective analysis and evaluation of an issue in order to form a judgment.

• Medical Terminology & Documentation (Expert): The ability to comprehend medical terminology and documentation in an office, or surgical setting.

• Compliance (Advanced): Understanding the rules, regulations, sanctions and other statutory requirements, guidelines and instructions relating to governing bodies and organizations, both internally and externally.

• Written Communication (Advanced): Demonstrates the ability to write clear, detailed, and comprehensive status reports, memos and documentation. Demonstrates an understanding of effective composition, such as having first line in a paragraph state the subject.

• Verbal Communication (Advanced): Ability to enunciate clearly, using appropriate voice control and body language. Effectively transmits technical and business ideas and information to others. Listens carefully to ascertain points being made before trying to be understood.

Our professional administrative functions include critical supporting roles in information technology and informatics, finance, administration, legal and community affairs, human resources, communications and marketing, development, facilities, and many more.

At our growing health system, we support each other and encourage excellence among all who are part of our workforce. High-achieving employees stay at Vanderbilt Health for professional growth, appreciation of benefits, and a sense of community and purpose.

Core Accountabilities:

Organizational Impact: Delivers projects/assignments that have a direct impact on goals/objectives of the unit/department that the job is in. Problem Solving/ Complexity of work: Conducts extensive analysis of situations or data to resolve numerous, complex issues; may involve the input/work of others. Breadth of Knowledge: Has in-depth level of knowledge within a professional area and working knowledge of other areas. Team Interaction: May lead mid-sized projects; coaches and guides team members.

Core Capabilities :

Supporting Colleagues: - Develops Self and Others: Invests time, energy, and enthusiasm in developing self/others to help improve performance e and gain knowledge in new areas. - Builds and Maintains Relationships: Maintains regular contact with key colleagues and stakeholders using formal and informal opportunities to expand and strengthen relationships. - Communicates Effectively: Recognizes group interactions and modifies one's own communication style to suit different situations and audiences. Delivering Excellent Service: - Serves Others with Compassion: Seeks to understand current and future needs of relevant stakeholders and customizes services to better address them. - Solves Complex Problems: Approaches problems from different angles; Identifies new possibilities to interpret opportunities and develop concrete solutions. - Offers Meaningful Advice and Support: Provides ongoing support and coaching in a constructive manner to increase employees' effectiveness. Ensuring High Quality: - Performs Excellent Work: Engages regularly in formal and informal dialogue about quality; directly addresses quality issues promptly. - Ensures Continuous Improvement: Applies various learning experiences by looking beyond symptoms to uncover underlying causes of problems and identifies ways to resolve them. - Fulfills Safety and Regulatory Requirements: Understands all aspects of providing a safe environment and performs routine safety checks to prevent safety hazards from occurring. Managing Resources Effectively: - Demonstrates Accountability: Demonstrates a sense of ownership, focusing on and driving critical issues to closure. - Stewards Organizational Resources: Applies understanding of the departmental work to effectively manage resources for a department/area. - Makes Data Driven Decisions: Demonstrates strong understanding of the information or data to identify and elevate opportunities. Fostering Innovation: - Generates New Ideas: Proactively identifies new ideas/opportunities from multiple sources or methods to improve processes beyond conventional approaches. - Applies Technology: Demonstrates an enthusiasm for learning new technologies, tools, and procedures to address short-term challenges. - Adapts to Change: Views difficult situations and/or problems as opportunities for improvement; actively embraces change instead of emphasizing negative elements.

Position Qualifications:

Responsibilities:

Certifications:

LIC-Licensed Discipline Specific - Licensure-Others

Work Experience:

Relevant Work Experience

Experience Level:

5 years

Education:

High School Diploma or GED

Vanderbilt Health recognizes that diversity is essential for excellence and innovation. We are committed to an inclusive environment where everyone has the chance to thrive and to the principles of equal opportunity and affirmative action. EOE/AA/Women/Minority/Vets/Disabled