Job Description

Manager of Coding Integrity

New York City, New York

New York City has long been known for its dense population and cultural diversity. Divided into five boroughs, New York City is home to hundreds of attractions including Times Square, Rockefeller Center, the financial district, as well as thousands of restaurants and activities. Whether you are looking to relocate or are a current resident, job opportunities in New York City are abundant.

The Clinical Coding Quality Specialist is responsible for working with the QA Manager to ensure the quality and integrity of codes abstracted or validated by internal coding staff or vendors to ensure accurate coding compliance with proper medical record documentation. This will include building and managing relationships, processes and audits with vendors that result in accurate and complete submissions to health plans.

Manager of Coding Integrity Responsibilities:

Compile results, summarize findings, and report results, findings, and if applicable, develop action plans to address variant findings, on a quarterly basis for the Compliance and Revenue Cycle Committees
Serve as the liaison between the Coding and Documentation Integrity Section of and the Quality Department for matters such as Healthcare Acquired Conditions and Patient Safety Initiatives
Develop or recommend improvements/enhancements to documentation tools, provider engagement and/or processes related to documentation and related outcomes, as needed
Assist in reconciling query and non-query impact within the CDI data entry systems
Project management regarding clinical documentation initiatives and analysis of potential scope expansion or opportunity identification and resolution

Manager of Coding Integrity Qualifications:

Bachelor's Degree in Nursing, Medicine, Health Information Management or similarly related field of study
Current coding certification through AAPC or AHIMA (CPC, CCS, RHIT), CRC required
Thorough knowledge of and experience with facility coding and reimbursement including, but not limited to, ICD-10CM and PCS, DRG models, Severity of Illness, Risk of Mortality, Present on Admission and Discharge Disposition codes, as well as CPT-4, HCPCS, APCs/APGs/E-APGs models and HCCs
Experience and understanding of Medicare Risk Adjustment compliance rules and regulations and coding guidelines
5 years hospital coding experience in a mid-to-large acute care facility preferred

This job was posted on Mon May 16 2022 and expired on Tue May 17 2022.

Minimum $32K /yr

$89K /yr Average

Maximum $185K /yr

Tasks

Protect the security of medical records to ensure that confidentiality is maintained.

Review records for completeness, accuracy, and compliance with regulations.

Retrieve patient medical records for physicians, technicians, or other medical personnel.

Assign the patient to diagnosis-related groups (DRGs), using appropriate computer software.

Process patient admission or discharge documents.

Transcribe medical reports.

Resolve or clarify codes or diagnoses with conflicting, missing, or unclear information by consulting with doctors or others or by participating in the coding team's regular meetings.

Enter data, such as demographic characteristics, history and extent of disease, diagnostic procedures, or treatment into computer.

Identify, compile, abstract, and code patient data, using standard classification systems.

Release information to persons or agencies according to regulations.

Plan, develop, maintain, or operate a variety of health record indexes or storage and retrieval systems to collect, classify, store, or analyze information.

Prepare statistical reports, narrative reports, or graphic presentations of information, such as tumor registry data for use by hospital staff, researchers, or other users.

Post medical insurance billings.

Compile and maintain patients' medical records to document condition and treatment and to provide data for research or cost control and care improvement efforts.

Manage the department or supervise clerical workers, directing or controlling activities of personnel in the medical records department.

Compile medical care and census data for statistical reports on diseases treated, surgery performed, or use of hospital beds.

Train medical records staff.

Process and prepare business or government forms.

Consult classification manuals to locate information about disease processes.

Develop in-service educational materials.

Skills

Reading Comprehension - Understanding written sentences and paragraphs in work related documents.

Knowledge

Clerical - Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and other office procedures and terminology.

Computers and Electronics - Knowledge of circuit boards, processors, chips, electronic equipment, and computer hardware and software, including applications and programming.

English Language - Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.