Radiologic Technologist PRN OSSO Spine Center

Position Summary

We have an exciting opportunity to join our team as a Manager-Clinical Data Integrity. In this role, the successful candidate provides guidance for both internal and remote coding staff with training, coding compliance reviews, regulatory issues and monitoring of accounts receivable issues related to coding. Works closely with Patient Financial Services (PFS), Clinical Documentation Improvement Program and other services to assist and/or coordinate in resolving account, coding, and charge capture issues.

Manages the conversion of clinical documentation into data and information and the reporting of this coded data to internal users such as Clinical Departments, Patient Financial Services, Admitting and external agencies such as IPRO, Med Review, NYCHPRO and other agencies as required. Ensures that coding practices and processes comply with applicable regulatory guidelines and requirements. Participates in the special projects when necessary.

• Provides guidance and expertise in ICD-10 and CPT-4 coding systems as well as MS-DRG, APR DRG, APC and APG. Provides leadership and expertise in data query and reporting. Manages the conversion of clinical documentation into meaningful data. Responsible for information reporting to internal and external users. Understands the general flow of health information from discharge, coding, billing and data reporting. Assists the Directors of Coding and CDI in implementing efficient workflows and practices.
• Conduct routine internal audits of coded data and physician documentation, report the results and recommend corrective action as needed.
• Develops materials and/or educational sessions to provide feedback and revenue cycle compliance training to clinicians, HIM professionals, and other hospital employees.
• In collaboration with Directors of CDI and Coding identifies area that will require extensive physician education.
• Assists the Director of Coding with developing and maintaining coding and documentation quality and compliance program. Ensures that coding process and guidelines meet State and Federal requirements and standards. Works with the medical staff to continuously improve clinical documentation to facilitate accurate coding. Enforces the use of physician query when appropriate.
• Identifies potential compliance risks and offers recommendations for preventive and quality improvements.
• Identifies patterns and opportunities for improvement through participation in hospital initiatives, such as Quality Initiatives, Clinical Documentation Improvement Program, Compliance, and results of outside audits, such as RAC reviews.
• Provides consultative advice to outpatient and ancillary departments as well as Patient Financial Services regarding their coding questions and needs. Acts as liaison with hospital personnel and outside agencies on code assignments and resolves operational problems.
• Meets performance standards by setting goals and objectives, prioritizing work, and using available resources efficiently and effectively.
• Stays current on new practices and regulations; evaluates risks from external reports such as PEPPER reports and facilitates action plans with departments and sites, as appropriate.
• Stays abreast of the latest developments, advancements, and trends in the field of Coding and Reimbursement by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and maintaining certification or licensure. Integrates knowledge gained into current work practices.

• Bachelors Degrees and a minimum of five years of experience working in HIM/revenue cycle compliance in a consulting capacity or in a hospital setting.
• In-depth knowledge and…