- Conducts admission/continued stay reviews accurately using the coding guidelines and documentation guidelines to clarify conditions/diagnoses and procedures where inadequate or conflicting documentation exists.
- Analyzes and interprets clinical data to identify gaps, inconsistences, or opportunities for improvement in the clinical documentation and appropriately queries the provider using a compliant query based on the AHIMA Guidelines for compliant query practice.
- Follow open queries to ensure physician response.
- Validates DRG assignment with medical record documentation, ICD-10-Official Coding guidelines and supporting clinical indicators.
- Facilitates and secures accurate clinical documentation to ensure that appropriate reimbursement is received for the level of service rendered to all patients.
- Demonstrates knowledge of DRG payor issues, clinical documentation requirements and referral policies and procedures.
- Develops collaborative relationships and promotes team work with co-workers and other departments.
- Maintains a positive and supportive attitude towards the mission and goals of Catholic Health Services.
- Educates members of the team on clinical documentation opportunities, coding and reimbursement issues as well as performance improvement opportunities and methods.
- Assists in educating physicians regarding documentation to the highest level of specificity of all conditions and complications being addressed and treated.
- Collaborates with HIM staff to insure proper code assignment.
- Maintains strict patient confidentiality, adhering to HIPPA Guidelines.
- Refers quality issues (HAC/PSI) to the appropriate resource.
- Performs validation of ICD-10-CM/PCS codes after coding and prior to bill drop.
- Proficient in assigning baseline and final MS/DRG and APR DRG in the CDI tracking tool utilizing coding and reimbursement tools , with knowledge of CDI impact on the case.
- Proficient in accurately entering queries and MD/MLP responses in the CDI tracking tool.
- Proficient in data entry and completion of CDI reviewed cases in the CDI tracking tool with attention to detail in order to avoid missing data.
- Knowledge of current insurance denial trends and CDI's role in denial prevention.
- Participates in seminars and workshops to keep current with all coding revisions.
- Maintains credentials by obtaining adequate continuing education.
- Must have strong current clinical knowledge and be able to collaborate with healthcare professionals in an efficient effective professional manner.
- Candidate needs to be self-motivated, self-directed, and able to work independently with minimal supervision. Must also be well organized and detail oriented.
- Must be able to read, understand and apply ICD-10 Official Coding Guidelines (after training).
- Must have excellent communication skills, both verbal and written.
- Possesses the ability to educate health care professionals in various settings.
- Demonstrated proficiency in Microsoft Work, Excel, Windows and Power Point required. Must be self -directed and willing to mentor new staff entering the specialty as well as possessing the ability to meet production expectations and quality of review standards.
- Must be able to meet or exceed deadline completion times regarding report submissions and bill hold reconciliation. Responsibilities to include other duties as assigned. Adheres to all approved AHIMA coding guidelines.
- Registered Nurse (BSN preferred), Nurse Practitioner or Physician Assistant licensed to practice in the State of New York, required
- Completion of ICD-10-CM/PCS coding class within 6 months of employment.
- CCDS certification required within 2 years of hire date.
-
Catholic Health Smithtown, United StatesCatholic Health is one of Long Island's finest health and human services agencies. Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island. · At Catholic Heal ...
-
Business Process Improvement Specialist
2 days ago
ASML US, LLC Wilton, United StatesInternal candidates only · Introduction to the job Exciting role for a Business Process Specialist in ASML's Business Adoption Team (BAT), specializing in Planning. Requires expertise in the domain, collaborative problem-solving skills, and the ability to navigate change. Key re ...
-
Quality Improvement Specialist
2 days ago
Maryhaven Port Jefferson Station, United States**Job Summary**: · Previews in-house programs to ensure maximum compliance with regulations; focus towards ensuring quality of care for the service recipients through guidance and assisting site staff. Participates in investigative procedures and techniques in accordance with fed ...
-
Clinical Quality Improvement Specialist
2 weeks ago
Northwell Health Riverhead, United StatesJob Description · Participates in interdisciplinary and process improvement teams to identify potential future uses of the information systems and potential improvements in the current use of the systems. Serves as a nursing informatics resource, to individuals and teams within P ...
-
Quality Improvement Specialist
2 weeks ago
Northwell Health Manhasset, United StatesJob Description · Maintains data repository and conducts analysis of activities related to Quality Management initiatives. Provides technical support in the development and analysis of data. · Job Responsibility · Supports an information system for Quality Management data aggreg ...
-
Quality Improvement Specialist
1 week ago
Northwell Health Manhasset, United StatesJob Description · Job Description · Maintains data repository and conducts analysis of activities related to Quality Management initiatives. Provides technical support in the development and analysis of data. · Job Responsibility Supports an information system for Quality Mana ...
-
quality improvement specialist rn
3 weeks ago
St. Catherine of Siena Farmingdale, NY , USA, United StatesOverview · Work for one of the largest healthcare systems on Long Island. At Catholic Health Home Care we provide not only strong talented leaders, but we foster your growth. We offer flexible schedules, competitive health benefits and continuing education benefits. · Job Details ...
-
Patient Experience Improvement Specialist
1 week ago
NYU Langone Mineola, United StatesJob Description · NYU Langone Hospital-Long Island is a 591-bed university-affiliated medical center, which offers sophisticated diagnostic and therapeutic care in virtually every specialty and subspecialty of medicine and surgery. We are a major regional healthcare resource with ...
-
Clinical Quality Improvement Specialist
2 weeks ago
Northwell Health Riverhead, United StatesJob Description · Participates in interdisciplinary and process improvement teams to identify potential future uses of the information systems and potential improvements in the current use of the systems. Serves as a nursing informatics resource, to individuals and teams within P ...
-
MILFORD REGIONAL MEDICAL CENTER Milford, United States**Monday - Friday, 40 hours, 8-hour daytime, 8:00 AM - 4:30 PM, No weekends or Holidays** · **Milford Regional Medical Center** is a full-service, community and regional teaching hospital located in Milford, Mass. and serves patients from more than 20 towns in Central Massachuset ...
-
Clinical Quality Improvement Specialist
3 weeks ago
Northwell Health Manhasset, United StatesReq Number 122496 · Job Description · Participates in interdisciplinary and process improvement teams to identify potential future uses of the information systems and potential improvements in the current use of the systems. Serves as a nursing informatics resource, to individual ...
-
Hematologist Oncologist
3 weeks ago
New York Cancer & Blood Specialists Smithtown, United StatesNew York Cancer & Blood Specialists · Hematologist Oncologist Opportunity · Smithtown: NY · Full-Time · About the Practice and their Mission · New York Cancer & Blood Specialists is seeking an experienced, BC/BE Hematologist Oncologist to join our extensive, well-established, mul ...
-
Residential Manager
20 hours ago
Family Residences and Essential Enterprises, Inc. Smithtown, United States Full time (Eligible for Benefits)Overview · ORGANIZATION SUMMARY · Family Residences and Essential Enterprises, Inc. (FREE) benefits and proudly supports more than 4,000 individuals with intellectual / developmental disabilities, mental illness and traumatic brain injury. It is the mission of FREE to support p ...
-
Supervisor Clinical Operations
1 week ago
Upward Health Hauppauge, United StatesSupervisor, Clinical Operations · Upward Health is a home-based medical group specializing in primary medical and behavioral care for individuals with complex needs. We serve patients throughout their communities, and we diagnose, treat, and prescribe anywhere our patients call h ...
-
Technology Logistics Specialist
1 week ago
Upward Health Hauppauge, United StatesThe Technology Logistics Specialist is a key member of the Upward Health Technology Department, responsible for providing outstanding front line technical support for various end user systems, as well as helping to support and maintain Upward Health logistical operations. The ide ...
-
Audit Specialist
2 weeks ago
Contract Specialties Group Hauppauge, United StatesThe AS9100 Specialist is an advanced-level auditor performing in-depth system and procedural audits. This role is considered an expert in AS9100 and audit preparations. This position reports to the Quality Assurance Manager.Essential Functions: · Carry out internal audits of the ...
-
MDBW- NY Market
4 weeks ago
Inteplast Group Hauppauge, United States Full timeDescription/Job Summary · The Market and International Sales Specialist will work with all areas of the company to support Marketing and International Sales activities to grow sales. The role will support three primary initiatives: International Sales support, trade show managem ...
-
Supervisor Clinical Operations
6 days ago
Upward Health Hauppauge, United StatesSupervisor, Clinical Operations · Upward Health is a home-based medical group specializing in primary medical and behavioral care for individuals with complex needs. We serve patients throughout their communities, and we diagnose, treat, and prescribe anywhere our patients call h ...
-
Technology Logistics Specialist
6 days ago
Upward Health Hauppauge, United StatesThe Technology Logistics Specialist is a key member of the Upward Health Technology Department, responsible for providing outstanding front line technical support for various end user systems, as well as helping to support and maintain Upward Health logistical operations. The ide ...
-
Hematologist Oncologist
3 weeks ago
OneOncology Smithtown, United StatesNew York Cancer & Blood Specialists · Hematologist/Medical Oncologist Opportunity · Smithtown: NY · Full-Time · About the Practice and their Mission · New York Cancer & Blood Specialists is seeking an experienced, BC/BE Hematologist/Medical Oncologist to join our extensive, we ...
Clin Doc Improv Specialist - Smithtown, United States - St. Catherine of Siena
Description
OverviewCatholic Health is one of Long Island's finest health and human services agencies.
Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island.
At Catholic Health, our primary focus is the way we treat and serve our communities.We work collaboratively to provide compassionate care and utilize evidence based practice to improve outcomes - to every patient, every time.
We are committed to caring for Long Island. Be a part of our team of healthcare heroes and discover why Catholic Health was named Long Island's Top WorkplaceJob Details
The Clinical Documentation Improvement Specialist is responsible for improving the overall quality and completeness of clinical documentation within the inpatient record.
Performs concurrent reviews, facilitates modifications to the clinical documentation to accurately reflect the severity of illness and risk of mortality through extensive interaction with physicians, coding and other health care professionals; serves as a resource to improve capture and accuracy of the final coded DRG; able to meet daily production expectations, while impacting on the integrity of the in-patient record.
This position requires attention to detail and is production based.DUTIES/RESPONSIBILITIES:
POSITION REQUIREMENTS AND QUALIFICATIONS:
Education:
Skills:
Chart review skills with ICD-10-CM/PCS experience preferred.
Salary Range
USD $103, USD $129,560.00 /Yr.
This range serves as a good faith estimate and actual pay will encompass a number of factors, including a candidate's qualifications, skills, competencies and experience.
The salary range or rate listed does not include any bonuses/incentive, or other forms of compensation that may be applicable to this job and it does not include the value of benefits.
At Catholic Health, we believe in a people-first approach.In addition to the estimated base pay provided, Catholic Health offers generous benefits packages, generous tuition assistance, a defined benefit pension plan, and a culture that supports professional and educational growth.
