Clinical Documentation Improvement Supervisor

Conifer Revenue Cycle Solutions • College Station, TX

243d

About The Position

Collects and analyzes data to provide reports for hospital wide use and to make recommendations as appropriate. Participate in the planning, development and implementation, and ongoing success of the Clinical Documentation Management Program within the company. Educates members of the patient care team regarding documentation guidelines, including attending physicians, nursing, and other interdisciplinary team members. Responsible for reviewing medical records to facilitate and obtain appropriate physician documentation for any clinical conditions or procedures to support the appropriate severity of illness, expected risk of mortality, and complexity of care of the patient, by improving the quality of the physicians' clinical documentation and completeness of clinical documentation.

Requirements

• Three (3) or more years' experience in CDI.
• Knowledge of Medicare Part A and familiar with Medicare Part B.
• Knowledge of disease pathophysiology and drug utilization.
• Knowledge of MS-DRG classification and reimbursement structures.
• PC/Systems literate including the Internet and MS office skills.
• Ability to apply coding conventions, official guidelines, and Coding Clinic advice to health record documentation.
• Management of multiple priorities - effective time management skills.
• Leadership and organizational skills along with critical, deductive reasoning and problem solving skills.
• Effective written and verbal communication skills including report writing and presentation skills.
• Capacity to work independently in a virtual office setting or at facility setting if required to travel for assignment.
• Understand and communicate documentation strategies.
• Recognize opportunities for documentation improvement.
• Formulate clinically, compliant credible queries.
• Ability to maintain an auditing and monitoring program as a means to measure query process.
• Report writing with management review.
• Skilled in performing quality assessment/analysis.
• Detail oriented and analytical skills.
• Possesses the ability to motivate and maintain effective working relationships with staff and all stakeholders.
• Demonstrates strength in both performance management and leadership development.
• Manage change while minimizing interruption at an operational and service level.

Nice To Haves

• Graduate from a Nursing program, BSN, or graduate of Health Information Management RHIT, RHIA preferred.
• One (1) year supervisory experience or more.
• Active state Registered Nurse license or Certified Coding Specialist credential preferred.
• CDIP or CCDS preferred.
• RN, RHIT, RHIA, and CCS preferred.

Responsibilities

• Monitoring and Building CDI team
• Oversee and act as resource for Clinical Documentation Improvement departments across Conifer Health including monitoring daily activity and completion of performance and metric reports.
• Test, interview, hire and retain CDI staff.
• Lead meetings with team leads and CDI staff.
• Improve medical CMI.
• Oversee market CDI programs.
• Enforces company, departmental policies, practices, procedures and work rules in accordance with approved policies and assists in the development and implementation of new policies.
• Educates department and facility staff as needed.
• Communicates/Completes Clinical Documentation Improvement (CDI) activities and coding issues for appropriate follow-up and resolution.
• Develop a collaborative CDI and Coding team.
• Conducts analysis, identifies trends, validation of compliance as related to the clarity of documentation.
• Completes initial medical records reviews of patient records within 24-48 hours of admission for a specified patient population.
• Conducts follow-up reviews of patients every 2-3 days to support and assign a working or final MS-DRG assignment upon patient discharge.
• Formulate physician queries regarding missing, unclear or conflicting health record documentation.
• Collaborates with case managers, nursing staff and other ancillary staff regarding interaction with physicians regarding documentation.
• Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-9-CM.
• Attends mandatory coding seminars on annual basis for inpatient.
• Attends Quarterly Coding Updates and all coding conference calls as well as any required CDI education.

Benefits

• Competitive benefits package
• Resources and incentives to redefine healthcare services

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree