- Complete timely documentation reviews to assign principal diagnosis and pertinent secondary diagnoses for inpatients admitted emergently, urgently and electively and outpatient services for completeness.
- Use broad knowledge of quality medical documentation and regulatory directives, coordinates point of care and/or retrospective documentation improvement to address severity of illness and risk of mortality and to be further used for patient care, quality of care and performance measurement, and reimbursement. The multi-disciplinary process requires excellent communication and interactive skills with members of the healthcare team.
- Serve as a resource to physicians and administration regarding issues related to the appropriateness of Inpatient DRG assignments.
- Work collaboratively with the CDI Staff to facilitate documentation within the medical record that supports patient's severity of illness and risk of mortality utilizing strong communication skills with physicians, case managers, utilization reviewer, nurse or other healthcare professionals, utilizing appropriate querying tools to capture needed documentation.
- Manage individual(s) including, but not limited to, interviews, trainings, assigns work, manages and evaluates performance, conducts professional development plans. Ensures that the productivity and actions of that group meet/support the overall operational goals of the department as established by department leadership.
- Complete initial review of inpatient health records within 24-48 hours of admission and outpatient health records for a specified patient population to evaluate documentation to assign the principal diagnosis and pertinent secondary diagnoses for severity of illness and risk of mortality
- Query physicians regarding missing, under, or conflicting health record documentation and obtains additional documentation within the health record when needed
- Complete initial review of outpatient health records within 24 to 48 hours for a specified population to evaluate documentation to assign the principle diagnosis and pertinent secondary diagnosis for severity of illness and risk of mortality to meet the CMS two midnight rule.
- Demonstrate a thorough understanding of the Medicare Severity (MS)-DRG system, CCs/MCCs, impact on quality, and CMI as well as ICD-10-CM/PCS coding systems and the guidelines related to Clinical Documentation Improvement.
- Maintain CDI Dashboard and reports monthly analysis to the CDI Staff.
- Attend client's monthly Utilization Review Committee Meetings and coordinate any assignments related Clinical Documentation.
- Attend coding/financial educational programs and regulatory educational programs and updates as necessary to maintain expert knowledge base.
- Quarterly review of AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM/PCS.
- Attend Coding Updates and all coding conference calls as well as required CDI education.
- Prepare weekly team performance reports including weekly production, quality assessments and coding inventory reports, i.e., coding queries and submit to the manager for review.
- Mentor the CDI in building effective relationships with the providers they support.
- Coordinate employee's schedules, including vacation/sick request to ensure adequate coverage.
- Lead weekly team meetings with CDI staff.
- Foster an environment of teamwork and service excellence within the department.
- Educate physicians and key healthcare providers regarding clinical documentation Improvement and the need for accurate and complete documentation in the health record
- Demonstrate an understanding of medical necessity, severity of Illness, complications, comorbidities, risk of mortality, case mix, secondary diagnoses, and procedures, and is able to impart this knowledge to physicians and other members of the interdisciplinary healthcare team
- Collaborate with the physician advisor, case managers, nursing staff, and other ancillary staff regarding interaction with physicians on documentation and to resolve physician queries prior to patient discharge
- Participate in the analysis, interpretation and trending of statistical data for specified patient populations to identify opportunities for clinical documentation and process Improvement
- Assist with preparation and presentation of clinical documentation monitoring and trending reports for review with physicians and hospital leadership
- Educate members of the patient care team regarding specific documentation needs and reporting and reimbursement issues Identified through daily and retrospective documentation reviews and aggregate data analysis
- Facilitate change processes required to capture needed documentation, such as forms and screen design
- Partner with the coding professionals to ensure adequate coding understanding to support clinical documentation necessary to determine a working severity of illness
- Review and clarify clinical issues In the health record With the coding professionals that would support accurate and specific diagnoses and procedural coding
- Assist in appeal process resulting from third-party reviews
- Meet with the HIMS Coding Staff on a regular basis to participate in post-discharge coding reviews to ensure the most accurate DRG has been assigned and to identify opportunities for clinical documentation improvement for future cases.
- Perform other duties as assigned
- Bachelors degree from an accredited college of university
- Registered Health Information Technician (RHIT) OR a Registered Health Information Administrator (RHIA)
- Four (4) years of experience as a registered health information technician, or as a registered health information administrator OR a combination of the three totaling three (3) years of experience
- Two (2) year of experience within the last five (5) years working in Clinical Documentation Improvement
- Two (2) years of experience supervising and/or managing staff
- Two (2) year of experience working with Case Mix, ICD 10 coding, principal and secondary diagnoses, procedures, complications, comorbidities, severity and patient mortality risk
- Current experience with federal, state, and other payers' regulatory requirements and criteria including, but not limited to, Medicare and Medicaid
- Prior experience working in a hospital or health care environment
- Certified Documentation Improvement Practitioner (CDIP), or Certified Clinical Documentation Specialist (CCDS)
- Must be detail oriented for clinical documentation review
- Must be familiar with electronic health record systems, i.e., Cerner or Siemens
- Licensed as a Registered Professional Nurse in the State of Illinois
- Five (5) years of acute care nursing experience or as a registered health information administrator
- Two (2) years of experience within in the last three (3) years working in Clinical Documentation Improvement
- Two (2) years of experience working with Case Mix, ICD 10 coding, principal and secondary diagnoses, procedures, complications, comorbidities, severity and patient mortality risk
- Two (2) years of experience with federal, state, and other payers' regulatory requirements and criteria including, but not limited to, Medicare and Medicaid
- Current experience with InterQual and/or Milliman Care guidelines
- Certified Coding Specialist (CCS), Certified Coding Specialist – Physician-based (CCSP), or Certified Professional Coder (CPC)
- Registered Health Information Administrator (RHIA)
- Ability to develop and maintain supportive, collaborative relationships with Physicians and other clinical professional
- Ability to provide concise reports of activities and results.
- Ability to work independently in performing duties with minimal supervision with a high degree of self-motivation
- Ability to teach in a large group setting to educate healthcare providers about current documentation standards
- Ability to track activities and communication across multiple physician services and forums
- Ability to work with clinical manager, case management, and physicians to make clinical documentation improvements, i.e. change clinical documentation processes
- Ability to analyze problems and issues and understand the regulatory and reimbursement impact of those decisions
- Ability to become adaptable and self-motivated by staying abreast of CMS rules and regulations and incorporating those changes into daily practice
- Proficiency in Microsoft Office Suite (Word, Excel, and PowerPoint)
- Competitive Salary
- Paid Time Off
- Health, Vision & Dental Insurance
- Health Savings Account (HSA)
- Flexible Spending Account (FSA)
- Short & Long Term Disability
- 401 (K) with company match
- Life Insurance
-
Continuous Improvement/project Manager
2 weeks ago
Scale Virtually LLC Chicago, United StatesWe are growing Private Equity Real Estate Firm and Virtual Assistant company, in search of a strong Project/Continuous Improvement Manager with 3-5 years experience in managing multiple projects and initiatives across various entities as directed by Executive Leadership. · The Co ...
-
Project Manager, Process Improvement
1 week ago
Sidley Austin LLP Chicago, United StatesSummary: · The Process Improvement Project Manager works with the Director of Process Improvement and leaders across the Firm to implement organizational initiatives related to process improvement, goal setting, planning, collaboration, and project management to ensure ongoing cr ...
-
Data Manager, Continuous Quality Improvement
2 weeks ago
American College of Surgeons Chicago, United States**About the American College of Surgeons** · **Summary**: · The CQI Data Manager works with the department to provide oversight of data conversion process and data sets for all CQI registries and special projects. This role focuses on data quality, data validations and security e ...
-
Quality Improvement Manager
3 weeks ago
Melmark Berwyn, United States**General Responsibilities** · Oversees Melmark's Incident Management program, ensuring timely and thorough investigation of all incidents. Implements Melmark's Quality Improvement Plan through the collection and organization of information regarding safety, compliance, and healt ...
-
Manager of Quality and Performance Improvement
3 weeks ago
AURA STAFFING PARTNERS CHICAGO LLC Oak Park, United States**Hospital Quality Manager - Risk Management** · **Quality Manager - Risk Management** · **SUMMARY** · The Quality Manager plans, directs, and evaluates patient care; facilitates quality improvement efforts and regulatory requirements among the Medical Staff and Hospital departme ...
-
Manager for Continuous Improvement
6 days ago
Golden Gate Group Hometown, IL, United States FreelanceContinuous Improvement Manager (m/f/d) for Hometown, IL · Simply excellent prospects · We are a brand of I. K. Hofmann GmbH and offer the best jobs for specialists and executives at renowned companies. · Ready to climb the next level of excellence? We are looking for an innovativ ...
-
Continuous Improvement Manager
3 weeks ago
Lineage Logistics Chicago, United StatesDefines requirements for operations and ensures the implementation of Continuous Improvement strategies and initiatives to effectively meet or exceed business requirements & customer expectations. Assist in facilitating Lean activities, including Kai Continuous Improvement, Manag ...
-
Continuous Improvement Manager
16 hours ago
Legrand North America Chicago, United StatesPosition Description: · At a Glance · Legrand has an exciting opportunity for a Continuous Improvement Manager to join the FocalPoint Team in Chicago, IL. Focal Point has an immediate opening for a Continuous Improvement Manager to join our Operations team The Continuous Improv ...
-
Continuous Improvement Manager
3 weeks ago
Lineage Logistics Chicago, United StatesThe Continuous Improvement manager is an integral part of the site leadership team and having the ability to work and influence across all levels of the organization will be critical to the success of this role. This position is responsible for driving a culture of sustainable co ...
-
Manager, Operations and Improvement
3 weeks ago
American Dental Association Chicago, United StatesWho We Are: It all starts with purpose. · We are a purpose-driven nonprofit with a dynamic staff culture. · With a meaningful purpose, motivated staff, and excellent benefits, working here will definitely have you smiling The ADA's headquarters is located just steps from Chicag ...
-
Rsc Process Improvement Manager
2 weeks ago
ACE Hardware Oak Brook, United StatesOur Company · Can-do attitude? Motivated? Helpful? You've come to the right place. · At Ace, we're a place where you can make an impact. A place where your help is not only wanted, it's encouraged and celebrated. A _Chicago Tribune_ Top Workplace four years in a row. A place focu ...
-
Global Continuous Improvement Manager
2 weeks ago
McCain Foods USA, Inc. Oakbrook Terrace, United States**Position Title: Global Continuous Improvement Manager** · **Position Type**: Regular - Full-Time · **Position Location**: Othello · **Grade**: Grade 06 · **Requisition ID**: 28928 · **JOB SUMMARY**: · The Global Continuous Improvement (MDI) Manager is responsible for mentoring ...
-
Global Continuous Improvement Manager
2 weeks ago
McCain Foods USA, Inc. Oakbrook Terrace, United States**Position Title: Global Continuous Improvement Manager** · **Position Type**: Regular - Full-Time · **Position Location**: Oakbrook Terrace · **Grade**: Grade 06 · **Requisition ID**: 28928 · **JOB SUMMARY**: · The Global Continuous Improvement (MDI) Manager is responsible for m ...
-
risk and performance improvement manager
3 weeks ago
Universal Health Services Chicago, United StatesResponsibilities · JOB SUMMARY: · The Manager of Performance Improvement and Risk Management participates in performance improvement and risk management activities of the Hospital to reduce operational risk and keep the facility accredited within the guidelines of JC and other r ...
-
Clinical Documentation Improvement Manager
3 weeks ago
Keystone Advisors LLC Chicago, United StatesKeystone Advisors is looking for a Clinical Documentation Improvement Manager to join our team in Chicago, IL supporting one of our healthcare clients in the Illinois Medical District. · The Clinical Documentation Improvement Manager will complete timely documentation reviews to ...
-
Senior Project Manager, Process Improvement
1 week ago
Sidley Austin Chicago, United StatesSummary: · The Senior Project Manager, Process Improvement works with the Director of Process Improvement and leaders across the Firm to implement organizational initiatives related to process improvement, goal setting, planning, collaboration, and project management to ensure o ...
-
SkyWater Search Partners Chicago, United StatesChoose a job you love, and you will never have to work a day in your life. — Confucius · Continuous Improvement- Senior Maintenance Manager · Continuous Improvement- Senior Maintenance Manager · Job Tag: · #LI-JP1 · Posted: · March 04,2024 · Work with key business stakeholders ...
-
Data Manager, Continuous Quality Improvement
1 week ago
American College of Surgeons Chicago, United StatesAbout the American College of Surgeons · The American College of Surgeons is a professional and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for surgical patients. The College is dedicat ...
-
Data Manager, Continuous Quality Improvement
1 week ago
American College of Surgeons Chicago, United StatesAbout the American College of Surgeons · The American College of Surgeons is a professional and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for surgical patients. The College is dedicat ...
-
United States Gypsum Company Chicago, United StatesBe part of the Team. Build your future at USG. · Effectively leads the plant's continuous improvement function through creation and execution of a focused strategy around project selection and charter activities. · Ability to apply Continuous Improvement methodologies such as Le ...
Clinical Documentation Improvement Manager - Chicago, United States - Keystone Advisors LLC
Description
Job Description
Job DescriptionKeystone Advisors is looking for a Clinical Documentation Improvement Manager to join our team in Chicago, IL supporting one of our healthcare clients in the Illinois Medical District.
The Clinical Documentation Improvement Manager will complete timely documentation reviews to assign principal diagnosis and pertinent secondary diagnoses for inpatients admitted emergently, urgently and electively and outpatient services for completeness. Work collaboratively with the Clinical Documentation Improvement (CDI) Staff to facilitate documentation within the medical record that supports patient's severity of illness and risk of mortality utilizing strong communication skills with physicians, case managers, utilization reviewer, nurse, or other healthcare professionals, utilizing appropriate querying tools to capture needed documentation. Manage audits for external Centers for Medicare & Medicaid Services (CMS) Recovery Audit Tracker (RAC) Audit results. Review monthly audits of all internal coders for accuracy. Using broad knowledge and understanding of the Medical Severity (MS) Diagnosis-Related Group (DRG) system, complication or comorbidity (CC)/major complexity or comorbidity (MCC), impact on quality, and CMI as well as ICD-10-CM/PCS coding systems and the guidelines related to CDI.
Job Duties include but are not limited to the following:
Minimum Qualifications:
Preferred Qualifications & Certifications:
Compensation Package:
Powered by JazzHR
4ikOCoXZje