Cleveland Clinic Coding-Edu-Quality-Coord-I in Cleveland, Ohio

Job Summary:

Provides coding education to coders, reimbursement specialists, medical staff and others regarding documentation, reimbursement and data interpretation for inpatient and outpatient coded data. Provides one-on-one as well as classroom education. Acts as a coding expert resource. Conducts the quality review of inpatient and outpatient coding; maintains up-to-date coding guidelines and coding policy changes. Develops process improvement activities based on audit results.

Responsibilities:

  • Analyzes and evaluates clinical and operational systems relative to inpatient and outpatient reimbursement through chart review and other special study methods.

  • Makes recommendations for data quality improvements and revenue enhancements.

  • Monitors coding compliance via pre-billing coding, DRG and APC quality audits, case mix analysis, and compliance software reviews and through other methods.

  • Provides feedback to the coding management team and staff regarding ICD-9-CM/CPT-4 or ICD 10 CM/PCS coding and DRG/APC assignment and related clinical documentation.

  • Develops and maintains inpatient and outpatient electronic coding manuals to support quality coding on the Coding Sharepoint site.

  • Assists with and/or provides suggestions for continuing education topics and issues for coding staff.

  • Educates groups and individuals within HIM regarding coding, DRG and APC assignment and the reimbursement process.

  • Interacts and educates coding staff.

  • When appropriate, develops and maintains CCHS facilities coding guidelines in accordance with Official Coding Guidelines.

  • Provides coder education on all relevant issues which will impact technical coding in HIM. Provides orientation and trains Coding staff.

  • Assists with the analysis of case mix reports and other statistical reports.

  • Provides assistance with coding as workload permits.

  • Supports coding program initiatives.

  • Promotes good morale and cooperation.

  • Encourages others and values their input.

  • Shares information and seeks ways to add value both to the customer and to the team.

  • Acts as a liaison among all department managers, staff, physicians and administration with respect to coding issues.

  • Anticipates and responds to changing skills requirements.

  • Seeks opportunities to learn new skills.

  • Coaches and encourages team members to do the same.

  • Successfully integrates team into the coding process to promote their development.

  • Complies with CCHS and departmental policies and procedures consistently.

  • Other duties as assigned.

Education:

  • High School Diploma is required.

Certifications:

  • For Health Information Management Candidates: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) is required and must be maintained.

  • For Clinical Institute Candidates: Certified Professional Coder (CPC) is required and must be maintained.

Complexity of Work:

  • Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.

  • Must be able to work in a stressful environment and take appropriate action.

Work Experience:

  • A minimum of two years of experience in a clinical environment involving the accurate interpretation and coding/abstraction of therapeutic/diagnostic measures and procedures of a diverse patient population. In-depth knowledge of ICD-9-CM (ICD-10-CM) coding principles, DRG assignment, APC assignment, and modifier assignment.

  • Formal coursework in anatomy, physiology and medical terminology in order to accurately interpret the medical record.

  • Working knowledge of both personal computer applications and mainframe computer systems.

  • Excellent verbal and written communications.

  • Must be detail oriented and analytical in nature.

  • A Bachelor's Degree in Health Information Management may substitute for up to one year of required experience.

Physical Requirements:

  • Physical demands require standing, walking, sitting, lifting, carrying up to 25 lbs.

  • Close, distant, and color vision is required.

  • Requires manual dexterity to grasp and handle records and to operate a PC computer in the course of work.

  • The work environment is at a moderate noise level (business office with phones, copiers, computers, and printers).

Personal Protective Equipment:

  • Follows Standard Precautions using personal protective equipment as required for procedures. #LI-KD1

The policy of Cleveland Clinic and its system hospitals (Cleveland Clinic) is to provide equal opportunity to all of our employees and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. Job offers will be rescinded for candidates for employment who test positive for nicotine. Candidates for employment who are impacted by Cleveland Clinic’s Smoking Policy will be permitted to reapply for open positions after 90 days. Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic facility.

Cleveland Clinic is pleased to be an equal employment employer: Women/Minorities/Veterans/Individuals with Disabilities