Description
MaineHealth Corporate
Management/Leadership
Req #: 79190
Summary:
This position manages HIMs Clinical Data Section, which is accountable for: coding and abstracting the medical records of inpatients; preparing statistical analysis of medical records data; compiling, analyzing and summarizing data from medical records into various formats. The output of this Section is used for: meeting hospital licensure requirements; financial and billing purposes, which includes the identification and determination of appropriate reimbursement under inpatient prospective payment systems; maintenance of acceptable accounts/receivables and DNB levels; compliance with internal and external regulatory agencies, such as Quality Improvement Organizations, the Centers for Medicare & Medicaid Services, and Joint Commission. The position also coordinates hospital DRG activities through chart reviews, DRG validation activities, and provides information and reports to fulfill requests made by members of the medical staff, administration and planning.
#LI-Remote
Required Minimum Knowledge, Skills, and Abilities (KSAs)
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Education: See experience.
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License/Certifications: Have current coding certifications for ICD
- Skilled in ICD coding and case mix index management. Experienced with EPIC, HP CDM, claim edit processes, 3M encoder and CDI programs. Prior CAC and Lawson a plus.
- Experience: A minimum of four years' prior successful supervisory experience. Advanced education which should include communication and mathematical/statistical skills and/or extensive knowledge in organization, research and analysis normally acquired through the completion of Health Record Administration/Science Bachelor's program with certification as an RHIA and coding credentials (CCS, CPC). Credentials are a job requirement and RHIT may be substituted for RHIA credentials provided held in conjunction with CCS and/or CPC certification.
- Full working knowledge of: medical information and revenue cycle systems; Grouper and Severity of Illness Systems; medical record systems, medical terminology, anatomy, physiology, pathophysiology, microbiology, and pharmacology; State, Federal and Joint Commission requirements pertaining to medical records; MS DRG prospective payment system.
- Has a good understanding of Clinical Documentation Improvement Programs to effectively collaborate with the Coders and CDI Nurse team, assisting with facilitating the CDI Task Force Meetings as well as CDI Leadership Meetings. Works well with Physician CDI leadership to appropriately identify documentation improvement standards.
- Demonstrated abilities to: correctly interpret and apply Federal regulations and PRO requirements in the assignment of DRG's and in the interpretation of various billing guidelines (i.e., medical necessity, resident supervision policies, correct coding initiative, etc. Ability to direct concurrent and retrospective coding reviews and provide physician education for ICD 10 CM and PCS.
- Effective skills in leadership, communications, coaching, planning, motivation, and establishing effective working relationships with at all levels of staffing in the organization.
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MaineHealth will never request financial information during the interview or pre-hiring process. All legitimate communications will come from an email address ending in @mainehealth.org. If you suspect fraudulent activity, please report it immediately to [email protected].
Additional Information
With a career at any of the MaineHealth locations across Maine and New Hampshire, you’ll be working with health care professionals that truly value the people around them – both within the walls of the organization and the communities that surround it.
We offer benefits that support an individual's needs for today and flexibility to plan for tomorrow – programs such as paid parental leave, a flexible work policy, student loan assistance, training and education, along with well-being resources for you and your family.
MaineHealth remains focused on investing in our care team and developing an inclusive environment where you can thrive and feel supported to realize your full potential. If you’re looking to build a career in a place where people help one another deliver best-in-class care, apply today.
If you have questions about this role, please contact [email protected]
