Inpatient Coding and Clinical Documentation Improvement Manager
4 weeks ago
Job Summary
We are seeking a highly skilled Inpatient Coding and Clinical Documentation Improvement Manager to join our team at Minnesota Visiting Nurse Agency. This full-time role will primarily work remotely and will be responsible for leading the coordination and collaboration of health information, inpatient clinical documentation, and inpatient coding within our systems to ensure an effective and consistent reflection of care provided while ensuring compliance, quality, and financial viability.
Key Responsibilities
Manage and strategically direct the hospital billing, inpatient coding, and clinical documentation improvement teams to achieve business unit goals in targeted areas such as unbilled accounts receivable, compliance with regulatory requirements, coding data accuracy, and reimbursement from third-party payors.
Prepare and oversee budgets; hire, discipline, and terminate employees; develop staff to ensure the department meets the service needs of the organization.
Conduct employee performance evaluations and reviews, annual salary reviews, and performance documentation and discussion.
Coordinate and prioritize inpatient coding and CDI workflow.
Oversee scheduled work hours; monitor staffing, time cards, overtime, vacations, and time off.
Conduct departmental staff meetings and ensure new employee training is completed and training for all employees is current and ongoing.
Assist employees in solving problems as necessary and monitor accuracy, efficiency, and productivity of all inpatient coding personnel to ensure compliance with departmental performance standards.
Develop and maintain budgets for the hospital billing, coding, and CDI department and develop and maintain all policies and procedures pertaining to the Clinical Documentation Improvement Program, inpatient coding, and specific duties related to each of these areas.
Build a cohesive team by establishing clear direction, goals, and responsibilities and support the team's success by providing necessary resources and breaking down barriers.
Ensure compliance with CMS regulations, Local Medicare Carrier Review Policies (LMRP), Local Carrier Determinations (LCD), the AMA, and applicable HCMC compliance policies, as well as any relevant accrediting and payer organizations.
Develop long-range plans for work teams' activities and monitor results to ensure compliance with expectations for Clinical Documentation Improvement and Inpatient Coding functional areas.
Abstract and compile data that contribute to measuring and improving provider medical record documentation and design, prepare, and distribute meaningful reports using multiple databases.
Manage audit processes of medical record documentation and facilitate monitoring, tracking, and trending of audit results. Collect and organize data from multiple sources such as Epic, Doc-MS, departmental databases, etc. Communicate audit results to identified and appropriate audiences.
Develop, implement, and maintain quantity and quality performance improvement standards and monitor the quality and quantity of work produced by clinical documentation specialists and inpatient coders.
Participate in the development of the Clinical Documentation Improvement and Inpatient Coding strategy and manage supporting projects under the guidance of the Health Information Management Director and the Assistant Medical Director of Documentation Quality to ensure timely completion deadlines.
Coordinate education to providers regarding overall documentation and coding requirements for inpatient records, including elements for complete documentation availability, documentation integrity, provider fee billing, compliance, patient profiling, and facility coding/billing.
Implement strategies to address audit results that identify areas of opportunity related to physician documentation to minimize risk related to external auditors (e.g., RAC, MIC, ZIP, etc.) regarding quality, profiling, coding, and reimbursement measures.
Lead the communication effort with physicians, physician leaders, administrative leaders, and other stakeholders regarding the progress, success, and opportunities of the program on a regular basis.
Work collaboratively as a key participant in the development and implementation of system enhancements and modifications of coding workflows.
Facilitate the collection of information to provide ongoing feedback to physicians on work performance to ensure accuracy and consistency with all coding.
Assist Revenue Cycle management with the development and implementation of administrative policies, procedures, and guidelines for departmental operations and responsible for periodic evaluation of operational processes to assess relevancy to changing goals and objectives of the department.
Manage the PSI/HAC review program in conjunction with the Quality Performance Department.
Coordinate the escalation of documentation queries and issues to Physician Liaison's as needed and work with clinical department physician chairmen to obtain timely completion of queries and provide physician education.
Develop and plan educational programs to providers about quality documentation, ICD coding, profiling, and hospital metrics.
Facilitate the resolution of coding documentation issues and DRG mismatches.
Perform other duties as assigned.
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Minneapolis, Minnesota, United States Minnesota Visiting Nurse Agency Full timeJob Title:Inpatient Coding and Clinical Documentation Improvement ManagerJob Summary:We are seeking an experienced Inpatient Coding and Clinical Documentation Improvement Manager to join our team at Minnesota Visiting Nurse Agency. This full-time role will be responsible for leading the coordination and collaboration of health information, inpatient clinical...
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