Collaborates with clinical documentation team in the review of inpatient accounts (with an emphasis on mortality reviews) identifying documentation improvement opportunities
Assess DRG, PDx, secondary Dx, PCS, POA and all other components of documentation that impact quality metrics
Consistently assures coding practices remain compliant with coding guidelines and regulations
Continually identifies educational opportunities related to coding and documentation
Expert educator to clinical teams and medical staff
Identifies strategic plans that will result in a positive impact to the clinical dashboard
Develops clinical relationships across the health system securing interdepartmental support necessary for successful implementation of education strategies assuring achievement of overall strategic targets
Ability to multi-task a variety of audits
Ability to analyze data and construct appropriate action plans
Develops teaching tools to promote quality outcomes
Is an active member of clinical and executive meetings as identified
Advanced understanding of quality metrics for health system (Vizient, PSI, USNWR)
Partners with Coding, Clinical Documentation leadership and Medical Directors to coordinate, maintain, and execute advanced project work that includes but, is not limited to, Mortality Review, HAC/PSI Review, Quality Abstraction and Analysis, and/or special and non-traditional project work.
Partners with NM departments that includes but is not limited to: IT; Analytics; and Innovation to design and implement new and advanced workflow solutions.
Partners with third-party consultants/partners to contribute to workflow and methodology build and refine as necessary.
Required:
RHIT or RHIA or CCS Certification
Certified Clinical Documentation Specialist
Bachelor Degree - Healthcare field related OR completion of an Associate's Degree with five plus years of healthcare coding experience.
Clinical expertise and understanding achieved through prior experie
Benefits
Health insuranceVision insuranceRemote work options
Additional Information
Required:
RHIT or RHIA or CCS Certification
Certified Clinical Documentation Specialist
Bachelor Degree - Healthcare field related OR completion of an Associate's Degree with five plus years of healthcare coding experience.
The Coding Quality Auditor and Specialist reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. The Coding Quality Auditor and Specialist is required to be the expert in the work related to clinical documentation and coding. This position works in tandem with the Clinical Documentation Team assuring quality metrics are held to the highest standard for NM Health System.
The Coding Quality Auditor and Specialist is responsible for assuring coding guidelines and regulations are not compromised during the decision-making process related to clinical documentation and the coding of this documentation. This position partners with Clinical Documentation Nurses, Physicians, and other licensed providers to improve the quality of documentation, assuring best quality performance and representation of care provided. In addition, the Coding Quality Auditor and Specialist collaborates with the CMOs to ensure the integrity of the Health Record is established through best practices in Clinical Documentation and Coding.
The Coding Quality Auditor and Specialist is responsible for maintaining quality work queues and quality reports, advanced and complex project work that includes, but is not limited to, Risk Adjustment, Mortality Review, Hospital Acquired Condition (HAC) and Patient Safety Indicator (PSI) Review, Quality Abstraction and Analysis, and/or special and non-traditional project work. Incumbents to this role have a mastery of advanced clinical documentation integrity and quality concepts, coupled with the ability to consistently identify root causes and deliver measurable results. Key to this role is the ability to lead and facilitate quality initiatives and external rankings initiatives while remaining compliant within the coding guidelines and regulations.
The Coding Quality Auditor and Specialist solves complex problems and adds new perspectives to existing solutions. The Coding Quality Auditor and Specialist applies advanced knowledge of the national quality agenda and clinical documentation integrity and coding compliance to advance problem analysis and creative process redesign for Northwestern Medicine.
This position is 100% remote (occasional onsite meeting attendance may be requested)
Northwesternmedicine · Chicago, IL