Coding Quality Auditor & Specialist
类别：卫生保健地点：编码质量审计师和专家负责确保与临床文件及该文件编码有关的决策过程中不受到影响，并确保编码指导方针和法规。此职位与临床记录护士，医生和其他经营许可的提供商合作以提高文档质量，确保最佳质量的性能和所提供的服务代表性。此外，编码质量的审计师与专家还与 CMO 合作，以通过临床文件和编码方面的最佳实践来确保健康记录完整。编码质量审计师和专家负责维护质量工作队列和质量报告，先进和复杂的项目工作包括但不限于风险调整，死亡率审查，医院获得状况 (HAC) 和患者安全指标 (PSI) 评估，质量抽象和分析以及/或特殊和非传统的项目工作。该职位的成员掌握了高级临床文档完整性和质量概念，并有能力不断识别根源原因并提供可测量的结果。这一角色的主要功能是领导和促进质量倡议和外部排名计划的能力。编码质量审计师和专家解决复杂的问题，并为现有解决方案增加新视角。编码质量的审计师与专家对国家质量议程以及临床文档完整性和编码合规的先进知识进行了研究，以促进问题分析和创意过程。RESPONSIBILITIES §与临床文献团队合作审查住院账户 （重点放在死亡率检查）确定文件改进机会 §评估 DRG,PDx,二级 Dx,PCS,POA 和其他所有影响质量指标的文档组成部分 §持续确保编码实践保持符合编码指导方针和规则 §不断识别与编码和文档相关的教育机会 §专家教育临床团队，医疗人员和住院编码者 §确定将对临床仪表板产生积极影响的战略计划 §发展在整个卫生系统中临床关系，以确保成功实施教育策略所需的部门间支持
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Category: Health Care
Location:
The CodingQuality Auditor and Specialist is responsible for assuring coding guidelinesand regulations are not compromised during the decision-making process relatedto clinical documentation and the coding of this documentation.This position partners with ClinicalDocumentation Nurses, Physicians, and other licensed providers to improve thequality of documentation, assuring best quality performance and representationof care provided. In addition, the Coding Quality Auditor and Specialistcollaborates with the CMOs to ensure the integrity of the Health Record isestablished through best practices in Clinical Documentation and Coding.
TheCoding Quality Auditor and Specialist is responsible for maintaining qualitywork queues and quality reports, advanced and complex project work thatincludes but, is not limited to, Risk Adjustment, Mortality Review, HospitalAcquired Condition (HAC) and Patient Safety Indicator (PSI) Review, QualityAbstraction and Analysis, and/or special and non-traditional project work.Incumbents to this role have a mastery of advanced clinical documentationintegrity and quality concepts, coupled with the ability to consistentlyidentify root causes and deliver measurable results. Key to this role is theability to lead and facilitate quality initiatives and external rankingsinitiatives.
TheCoding Quality Auditor and Specialist solves complex problems and adds newperspectives to existing solutions. The Coding Quality Auditor and Specialistapplies advanced knowledge of the national quality agenda and clinicaldocumentation integrity and coding compliance to advance problem analysis andcreative process.
RESPONSIBILITIES
§Collaborates withclinical documentation team in the review of inpatient accounts (with anemphasis on mortality reviews) identifying documentation improvementopportunities
§Assess DRG, PDx,secondary Dx, PCS, POA and all other components of documentation that impactquality metrics
§Consistentlyassures coding practices remain compliant with coding guidelines andregulations
§Continuallyidentifies educational opportunities related to coding and documentation
§Expert educatorto clinical teams, medical staff and inpatient coders
§Identifiesstrategic plans that will result in a positive impact to the clinical dashboard
§Develops clinicalrelationships across the health system securing interdepartmental supportnecessary for successful implementation of education strategies assuringachievement of overall strategic targets
§Ability tomulti-task a variety of audits
§Ability to analyzedata and construct appropriate action plans
§Develops teachingtools to promote quality outcomes
§Is an activemember of clinical and executive meetings as identified
§Advanced understandingof quality metrics for health system (Vizient, PSI, USNWR, LeapFrog, AHRQ, CMS)
§Advancedunderstanding of clinical documentation and coding through the lens of localand national quality and ranking methodologies, including but not limited to,U.S News and World Report, Vizient, Leapfrog, the CMS Star Rating, AHRQ andpayer contracts and assists the Managers of Clinical Documentation and Codingin implementing key strategies to effect change.
§Partners withCoding, Clinical Documentation leadership and Medical Directors to coordinate,maintain, and execute advanced project work that includes but, is not limitedto, Mortality Review, HAC/PSI Review, Quality Abstraction and Analysis, and/orspecial and non-traditional project work.
§Partners with several departments that includes but is not limited to: IT; Analytics; and Innovationto design and implement new and advanced workflow solutions.
§Partners withthird-party consultants/partners to contribute to workflow and methodologybuild and refine as necessary.
Thisposition is 100% remote (occasional onsite meeting attendance may be requested)
Requirements
Required:
- RHIT or RHIA or CCS Certification
- Certified Clinical Documentation Specialist(will consider CDIP certification)
- Bachelor Degree – Healthcare related(will consider candidate currentlyenrolled in Bachelor program)
- Five years of coding experience in area of expertise
- Clinical expertise and understanding achieved through prior experience working with clinical documentation teams
- Strong personal computer skills (Word, Excel, PowerPoint, Visio)
- Excellent verbal, written, and presentation skills
- Demonstrates critical thinking skills
- Excellent interpersonal skills
- Planning and time management skills
- Educational/training experience
Preferred:
·Master’s Degree in related field orcurrently enrolled in Master’s program
ManagementResponsibility:
· This position will not have direct reports.
Benefits
Excellent benefits, perks and culture!
DetailsOriginally posted on Himalayas