Description
This position will report to the Director of Health Information Management Services and will be responsible for Data Quality and Education.This person will manage coding data compliance, coordinate the collection of data, serve as the expert for regulatory coding requirements related to both inpatient and outpatient coding and charges.
This position will be an integral participant in the enterprise wide implementation of ICD-10
This individual will facilitate a collaborative approach between Health Information Management Coding Professionals and all affected Departments.
Serves as a HIM subject matter expert (SME), ensuring the accurate and compliant representation of the coding, severity of illness and DRG assignment in the medical record.
Assume leadership role for ICD-10 implementation; coordinate education and training of coding personnel; coordinate preparation and transition for ICD-10 within the medical center.
Responsible for coordination of coding quality reviews, analysis of findings and education of coding staff.
Evaluates coding in accordance with ICD-9, CPT4 and HCPCS coding standards and Medicare Regulations for inpatient and outpatient coding and ensures compliance with coding guidelines and appropriate reimbursement.
This job function involves extensive record review, interaction with physicians, HIM professionals, and CDS staff. Active participation in team meetings and education of staff in coding process is a key component.
The incumbent will establish systems to monitor review and validate the accuracy of all coded and abstracted data.
The position is responsible for determining the integrity of the coded data by organizing and maintaining an internal Coding Quality Control Program to monitor the accuracy, analysis, consistency and completeness of coding. This will include the determination and establishment of acceptable coding error rates based upon coding industry standards.
The position requires collaboration with the medical Center Compliance and Quality Improvement office to review and ensure that coding audits and documentation improvement activities are managed as required.
The incumbent will perform duties of reviewing clinical documentation, reimbursement rates and assessing the accuracy of the code assignment and the collection of required data for use by researchers, reporting agencies and financial evaluation.
This individual will perform their duties within Health Information Management Services, and other areas that adhere to data collection requirements. The information compiled from this process would directly impact decisions made by the Medical Center Administrative Group and Financial Services and federal, state, and regulatory agencies.
Required Qualifications
- A minimum of three years experience working in a health care facility within the clinical environment.
- Three years coding in an acute care multi-facility teaching environment.
- The ability to interpret and analyze coding data , reports and performance measures
- Experience with and knowledge of various applications, data collection methodologies, and data entry.
- Demonstrated experience with system design, development and maintenance
BA/BS degree
Licensure/Certification
- Degree in Healthcare and Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) and Certified Coding Specialist (CCS)