Assistant Director, Medical Records

Lincoln Medical and Mental Health Center is one of New York City’s premier acute care hospitals. Located in Downtown Bronx, Lincoln is a teaching hospital renowned for its Centers of Excellence, and a recognized industry leader in the implementation of state-of-the art medical technology and best practices. Our team of highly trained and caring medical professionals is dedicated to providing the highest quality health care that is safe, compassionate, culturally competent and patient-centered.

Comprehensive services are offered in three major primary care areas:
Medicine, Pediatrics, and Women’s Health in addition to more than eighty (80) specialty services. At Lincoln, the safety and comfort of our patients is our number one priority.

At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.

8:00 A.M – 4:00 P.M;
Monday to Friday [35 Hours per Week.]

Under the direction of the HIM Director, the Assistant Director of HIM (Coding), analyzes provider documentation claims data, and assigned codes for all diagnoses and procedures to ensure accurate Diagnosis-Related Group (DRG) assignment. This role ensures that the most precise and comprehensive ICD-10-CM/PCS, CPT, and HCPCS codes appropriately support the patient’s clinical care and accurately reflect severity of illness and risk of mortality.

The individual conducts comprehensive quality reviews of medical records; validates the appropriateness of coding and DRG assignment; and provides expert guidance to promote consistency, accuracy, and efficiency in coding, data integrity and quality reporting.

• 1. Performs coding reviews to validate the completeness, accuracy, and specificity of code assignments for inpatient records in accordance with established coding guidelines and enterprise policies and procedures for appropriate DRG assignment. Ensures that all documented diagnoses and procedures are properly coded.
• 2. Validates the completeness, accuracy, and specificity of code assignments for Inpatient, Emergency Department and Ambulatory Surgery records, in accordance with established coding guidelines to support HCC capture and CRGs.
• 3. Participates in data quality reviews on inpatient records to validate the ICD-10 codes, MS-DRG, and APR-DRG, identify missed secondary diagnoses and procedures, PSIs, HACs and ensures compliance with all DRG mandates and reporting requirements. Analyze reports and identifies trends and statistical significance in quality metrics that will assist with focused as well as organizational process improvement.
• 4. Participates in the denials and appeals process by reviewing cases denied and making the determination whether or not a case is appealable by using pre-established criteria, based facility policies and procedures. Ensures denials are responded to in a timely manner. Provides feedback to facility coders, validators and physician advisors on opportunities in collaboration with CDI.
• 5. Assists in the development, implementation, and management of organizational strategy, initiatives, and/or budget and performance standards; communicates organizational objectives and goals.
• 6. Identifies and reports on cases with documentation inadequacies, inconsistencies, and other issues with opportunities for improvement and collaborates with enterprise CDI reviewers to provide feedback and education to facility coders, DRG validators and CDIs.
• 7. Generates physician queries as…