Jobs for People with MS: National MS Society

Responsibilities Job Description

Supervisor of Coding Quality & Support is responsible for supervising one or more coding and documentation education functions including Inpatient and Outpatient Clinical Documentation Improvement (CDI) to ensure delivery of education and services that supports timely and accurate documentation to reflect severity of illness and patient condition for the purpose of optimal care and quality. This role will ensure operational goals and objectives are met under the direction of the Coding Quality and Support leadership that includes both Coder, CDI and Provider Coding Quality Reviews, Provider Support, and cross-functional collaboration. Documentation is crucial to patient safety, optimal patient outcomes and success in research studies. Physician documentation, related diagnosis, and procedure documentation is integral to accurate coding, which is then used to determine hospital reimbursement, risk-adjust quality outcomes, patient severity of illness, and cost of care metrics.

This position will need to support the organization by analyzing documentation trends and creating plans for consistent improvement on key performance metrics to ensure accurate and appropriate diagnosis-related group (DRG) assignment by capturing comorbidities (CC) or major comorbidities (MCC) and quality metrics like severity of illness (SOI) and risk of mortality (ROM) in the inpatient setting. Additionally, optimizing the risk adjustment factor (RAF) score by documenting and reporting appropriate hierarchical condition categories (HCC) in the outpatient settings. The Supervisor of Coding Quality and Support works with information technology and clinical operations to improve documentation templates and alerts by disease type to support real time provider documentation to improve accuracy, specificity and help eliminate manual intervention.

This supervisor maintains a comprehensive knowledge of the EHR and departmental audit solutions, as well as inpatient, CDI and outpatient coding practices including acuity coding

Works with cross functionally to develop education plan based on analysis and prioritization to administer outreach and results defined by quality outcomes and frequency criteria. Evaluate and create the Annual Review and Education plan for coders and providers in partnership with corporate compliance. Based on organizational need, analysis of data, known compliance risks and documentation trends

• Participates and actively contributes to the selection, training, and evaluation of staff engaged in the performance of coding quality and support functions including prospective and retrospective reviews and associated education. Manages and evaluates performance, conducts professional development plans.

• Understands team requirements and leads teams to achieve performance outcomes ensuring team members industry knowledge is kept current creating fully functional and cross trained team performance

• Ensures self and team remain current with regulatory and payer requirements and implement people, process and technology changes needed to maintain ensure compliance.

• Coordinates, prioritizes and documents inpatient/outpatient coding and CDI educational workflows to ensure the greatest specificity, continuous efficiency, and process improvement. Works in concert with CDI teams to develop queries, workflows and priorities based on trends.

• Reviews work for accuracy and conformance with industry regulation and guidelines, departmental policies and procedures, tracks and monitors productivity and quality

• Demonstrates maturity and accountability for job performance, supports objectives and goals of the department and organization., Assess for areas of personal and professional growth.

• Analyze charging practices through financial and activity reports, as well as documentation review, to identify potential opportunities for revenue capture and recognize areas of compliance concern

• Works in concert with IP Coding, OP Coding and CDI team to develop queries, workflows and priorities based on trends.

• Supports the industry transition from fee for service payment models to value-based care payment models.

• Organize, analyze, and present data for the purpose of working with Department Leaders and other stakeholders throughout the organization to outline and institute strategies for improvement.

• Collaborate with key stakeholders to determine and address trends and educational needs. Make recommendations for efficiency related to edits / hold bills based on findings.

• Recommends additional system and industry education to improve performance outcomes.

• Evaluates self and team processes to ensure individual, team and organizational goals are met.

• Publish outcomes and benchmarks against national trends

Required

• Two-year degree in Business Administration, Health Care Administration, or related area PLUS 2 years of experience in health care reimbursement, financial management, coding OR an approved equivalent combination of education and experience

• 3 years of applicable business-related experience

• One of the following: Registered Nurse (RN), Certified Clinical Documentation Specialist (CCDS), Clinical Documentation Improvement Practitioner (CDIP), Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or comparable coding certificate and years of experience

Qualifications

$80100.80-$113068.80 / Annual

EEO Statement

EEO/AA Employer/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status

Benefit Overview

Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link for additional information: https://www.fairview.org/careers/benefits/noncontract

Compensation Disclaimer

The posted pay range is for a 40-hour workweek (1.0 FTE). The actual rate of pay offered within this range may depend on several factors, such as FTE, skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization values pay equity and considers the internal equity of our team when making any offer. Hiring at the maximum of the range is not typical.