CDI Manager

KPC GLOBAL MEDICAL CENTERS INC.•Santa Ana, CA

9d•$108,000 - $120,000

About The Position

The Manager Clinical Documentation Improvement (CDI) is responsible for managing CDI specialists and the CDI program, including recruiting, hiring, training, mentoring, and performance management. The role establishes and oversees organizational documentation-improvement processes and health-data collection to support accurate provider documentation and optimal reporting and reimbursement of health care services. The manager develops and implements strategic communication and education programs for CDI and its operations, assists with DRG denial responses and OSHPD reporting for OC hospitals, and takes primary responsibility for DRG optimization. The position also supports medical staff in improving documentation quality, serves as a reimbursement coding mentor, and participates in chart-review projects as assigned. Responsibilities include setting policies to improve reimbursement-coding outcomes; evaluating coding personnel and processes; reviewing and correcting reimbursement codes used in financial reports; instructing and managing Coding and CDI personnel; and ensuring accurate, ethical, and confidential coding, abstracting, and reporting. The manager reviews records, assigns diagnoses and procedures, applies relevant coding guidelines, ensures documentation is available, consults with medical staff, formulates effective queries, and provides education and feedback. The role also monitors coding status and uncoded records, prioritizes work, mentors staff, communicates effectively, meets productivity and quality standards, reports equipment malfunctions, manages supplies, and maintains continuing education and current AHIMA certification. The position works in a climate-controlled office. The listed physical requirements include prolonged sitting and standing, arm and hand dexterity, close and distant sight, color perception and hearing, and the ability to lift and move up to 25 pounds. The OSHA exposure category is II; the position does not involve routine exposure to bloodborne pathogens, though employment may require unplanned Category I tasks.

Requirements

At least three years of coding-systems experience in a hospital setting; the posting states “Minimum five (3) years.”
Two years of supervisory experience.
Certification or license as a Certified Coding Specialist (C.C.S.).
Knowledge of compliance and regulatory requirements, information systems, and Health Information Systems.
Knowledge of CPT, DRG, APC, and ICD-10-CM and ICD-10-PCS coding guidelines.
Successful completion of college-level courses in anatomy, physiology, medical terminology, and coding.
Experience managing Clinical Documentation Improvement Specialists in relation to clinical documentation.
Ability to meet the stated physical requirements, including prolonged sitting and standing, arm and hand dexterity, specified visual and hearing abilities, and lifting and moving up to 25 pounds.

Nice To Haves

Successful completion of or current enrollment in a program for certification as a Certified Coding Specialist (C.C.S.), Registered Health Information Technician (R.H.I.T.), or Registered Health Information Administrator (R.H.I.A.).
Experience using encoder software for code assignment in an acute-care setting.
Experience with the McKesson Intelligent Coding (Charging) application.

Responsibilities

Recruit, hire, train, mentor, and manage the performance of CDI specialists.
Establish and oversee the structure, processes, accountability, and health-data collection activities for documentation improvement.
Develop and implement strategic communication and education programs for CDI and its operations.
Assist with DRG denial responses and OSHPD reporting for OC hospitals.
Take primary responsibility for DRG optimization and help medical staff improve documentation quality; serve as a reimbursement-coding mentor.
Participate in chart-review projects as assigned.
Establish policies and implement changes to enhance reimbursement-coding outcomes.
Evaluate the effectiveness of coding personnel and processes.
Review reimbursement codes and monitor and correct them as applied to financial reports.
Provide instruction and manage Coding and CDI personnel.
Protect confidential patient information and limit access to those with a right and need to know.
Review medical-record documentation and accurately assign principal and secondary diagnoses and procedures.
Apply CPT conventions and AMA guidelines for surgical and diagnostic procedure coding, as well as AHA Coding Clinic guidance and hospital policy.
Abstract patient data accurately, complete required electronic-system elements, and follow department policy and UHDDS abstracting guidelines.
Ensure pertinent documentation is available for final coding and abstracting; address discrepancies in medical-record documentation appropriately.
Consult with medical staff to clarify diagnoses and procedures, and formulate clear, concise queries that support timely responses and accurate documentation and coding.
Serve as a liaison to medical staff by providing education and feedback to improve medical-record documentation.
Prioritize records for coding according to department policy, including STAT requests; update coding status and monitor uncoded records to support timely abstracting and coding.
Model professional conduct and mentor Coder staff, supporting their professional development.
Communicate clearly and concisely with requestors and perform assigned duties while maintaining a positive attitude.
Meet productivity requirements and quality standards.
Report equipment malfunctions and arrange service through appropriate personnel.
Inventory and order supplies regularly to maintain adequate stock.
Participate in continuing education and maintain CEUs required for certification or department policy, as well as current AHIMA certification.