HCA Healthcare
Medical Necessity Coding Compliance Coordinator
HCA Healthcare, Nashville, Tennessee, United States, 37247
Medical Necessity Coding Compliance Coordinator
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Medical Necessity Coding Compliance Coordinator
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HCA Healthcare . Overview This Work from Home position requires that you live within 60 miles of an HCA Healthcare Hospital. Our hospitals are located in the following states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA. Parallon, a part of HCA Healthcare, is seeking a Medical Necessity Coding Compliance Coordinator to coordinate reviews and compliance initiatives and maintain documentation of all NCDs/LCDs/LCAs identified for each facility/division. The coordinator identifies special requirements such as mandatory worksheets, medical necessity, documentation, licensure/certification, or other qualifications, and ensures applicable certifications or accreditations are met. This position also trends medical necessity write-offs and supports process improvement where write-off volumes are high. What you will do in this role Coordinate NCD/LCD/LCA review process at the Division level Determine whether new or revised NCDs/LCDs/LCAs apply to the hospital’s services, procedures and devices Ensure references including applicable NCDs, LCDs, LCAs, HCA Healthcare policies, enterprise tools, documentation toolkits, worksheets, and resources are available to hospital departments, physicians and Non-Physician Practitioners Monitor for NCD/LCD/LCA updates via regulatory communications and listservs to update appropriate departments and physicians Coordinate and assist with continuing education of hospital departments and medical staff related to NCDs/LCDs/LCAs Report key NCD/LCD/LCA activities to FECC, including high-priority items, action plans, and denial trends Monitor compliance with HCA Healthcare Policy REGS.GEN.011, Medicare – National and Local Coverage Determinations Conduct government/non-government medical necessity reviews and develop improvement plans based on findings Perform routine trends of write-offs and implement upfront reviews of high-volume/dollar NCD/LCD reviews Develop and implement education/improvement plans for assigned service lines Ensure clinical documentation requirements support accurate claims and identify areas for automation Act as general compliance SME for facility leaders Evaluate new service lines for medical necessity requirements Provide education to facility leaders on compliance, medical necessity, charge practices, and coding requirements Track all education and projects in the designated tracking tool What qualifications you will need Associates Degree required; equivalent work experience may substitute for education Minimum 3 years of hospital coding experience (preferred) Minimum 5 years of healthcare experience (hospital or clinical operations) Minimum 1 year NCD/LCD experience (preferred) Healthcare certification/licensure such as RHIT, CCS, CCP, CPC or other AHIMA-certified coding credential, LPN/LVN, RT, PT, etc., required Parallon provides full-service revenue cycle management and related services across the country. HCA Healthcare has been recognized as one of the World's Most Ethical Companies®. We encourage qualified candidates to apply. This description does not constitute a contract of employment and is subject to change at the company's discretion. Equal Opportunity 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. Employment details Seniority level: Mid-Senior level Employment type: Full-time Job function: Health Care Provider Industries: Hospitals and Health Care
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Join to apply for the
Medical Necessity Coding Compliance Coordinator
role at
HCA Healthcare . Overview This Work from Home position requires that you live within 60 miles of an HCA Healthcare Hospital. Our hospitals are located in the following states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA. Parallon, a part of HCA Healthcare, is seeking a Medical Necessity Coding Compliance Coordinator to coordinate reviews and compliance initiatives and maintain documentation of all NCDs/LCDs/LCAs identified for each facility/division. The coordinator identifies special requirements such as mandatory worksheets, medical necessity, documentation, licensure/certification, or other qualifications, and ensures applicable certifications or accreditations are met. This position also trends medical necessity write-offs and supports process improvement where write-off volumes are high. What you will do in this role Coordinate NCD/LCD/LCA review process at the Division level Determine whether new or revised NCDs/LCDs/LCAs apply to the hospital’s services, procedures and devices Ensure references including applicable NCDs, LCDs, LCAs, HCA Healthcare policies, enterprise tools, documentation toolkits, worksheets, and resources are available to hospital departments, physicians and Non-Physician Practitioners Monitor for NCD/LCD/LCA updates via regulatory communications and listservs to update appropriate departments and physicians Coordinate and assist with continuing education of hospital departments and medical staff related to NCDs/LCDs/LCAs Report key NCD/LCD/LCA activities to FECC, including high-priority items, action plans, and denial trends Monitor compliance with HCA Healthcare Policy REGS.GEN.011, Medicare – National and Local Coverage Determinations Conduct government/non-government medical necessity reviews and develop improvement plans based on findings Perform routine trends of write-offs and implement upfront reviews of high-volume/dollar NCD/LCD reviews Develop and implement education/improvement plans for assigned service lines Ensure clinical documentation requirements support accurate claims and identify areas for automation Act as general compliance SME for facility leaders Evaluate new service lines for medical necessity requirements Provide education to facility leaders on compliance, medical necessity, charge practices, and coding requirements Track all education and projects in the designated tracking tool What qualifications you will need Associates Degree required; equivalent work experience may substitute for education Minimum 3 years of hospital coding experience (preferred) Minimum 5 years of healthcare experience (hospital or clinical operations) Minimum 1 year NCD/LCD experience (preferred) Healthcare certification/licensure such as RHIT, CCS, CCP, CPC or other AHIMA-certified coding credential, LPN/LVN, RT, PT, etc., required Parallon provides full-service revenue cycle management and related services across the country. HCA Healthcare has been recognized as one of the World's Most Ethical Companies®. We encourage qualified candidates to apply. This description does not constitute a contract of employment and is subject to change at the company's discretion. Equal Opportunity 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. Employment details Seniority level: Mid-Senior level Employment type: Full-time Job function: Health Care Provider Industries: Hospitals and Health Care
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