Coding Quality Auditor and Specialist, HB Coding, Full-time, Days (Remote - Must reside in IL, IN, IA, WI, OH, MO, MI, or FL)

Northwestern Memorial Healthcare•Chicago, IL

1d•$33 - $47•Remote

About The Position

The Coding Quality Auditor and Specialist reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. This position requires expertise in clinical documentation and coding, working in tandem with the Clinical Documentation Team to ensure quality metrics are held to the highest standard for the NM Health System. The role is responsible for ensuring coding guidelines and regulations are not compromised during decision-making processes related to clinical documentation and its coding. It involves partnering with Clinical Documentation Nurses, Physicians, and other licensed providers to enhance documentation quality and ensure the best representation of care provided. Additionally, the Coding Quality Auditor and Specialist collaborates with CMOs to establish the integrity of the Health Record through best practices in Clinical Documentation and Coding. This role also involves maintaining quality work queues and reports, undertaking advanced and complex project work such as Risk Adjustment, Mortality Review, Hospital Acquired Condition (HAC) and Patient Safety Indicator (PSI) Review, Quality Abstraction and Analysis, and/or special and non-traditional project work. Incumbents possess mastery of advanced clinical documentation integrity and quality concepts, with the ability to consistently identify root causes and deliver measurable results. Key aspects include leading and facilitating quality and external rankings initiatives while maintaining compliance with coding guidelines and regulations. The position solves complex problems, adds new perspectives to existing solutions, and applies advanced knowledge of the national quality agenda and clinical documentation integrity and coding compliance to advance problem analysis and creative process redesign for Northwestern Medicine. This position is 100% remote, with occasional onsite meeting attendance potentially requested.

Requirements

RHIT or RHIA or CCS Certification
Certified Clinical Documentation Specialist
Bachelor Degree – Healthcare field related OR completion of an Associate's Degree with five plus years of healthcare coding experience.
Clinical expertise and understanding achieved through prior experience working with clinical documentation teams
Strong personal computer skills (Word, Excel, PowerPoint, Visio)
Excellent verbal, written, and presentation skills
Demonstrates critical thinking skills
Excellent interpersonal skills
Planning and time management skills
Educational/training experience

Nice To Haves

Master’s Degree in related field or currently enrolled in Master’s program

Responsibilities

Collaborates with clinical documentation team in the review of inpatient accounts (with an emphasis on mortality reviews) identifying documentation improvement opportunities
Assess DRG, PDx, secondary Dx, PCS, POA and all other components of documentation that impact quality metrics
Consistently assures coding practices remain compliant with coding guidelines and regulations
Continually identifies educational opportunities related to coding and documentation
Expert educator to clinical teams and medical staff
Identifies strategic plans that will result in a positive impact to the clinical dashboard
Develops clinical relationships across the health system securing interdepartmental support necessary for successful implementation of education strategies assuring achievement of overall strategic targets
Ability to multi-task a variety of audits
Ability to analyze data and construct appropriate action plans
Develops teaching tools to promote quality outcomes
Is an active member of clinical and executive meetings as identified
Advanced understanding of quality metrics for health system (Vizient, PSI, USNWR)
Advanced understanding of clinical documentation and coding through the lens of local and national quality and ranking methodologies, including but not limited to, U.S News and World Report, Vizient, Leapfrog, the CMS Star Rating, and payer contracts and assists the Managers of Clinical Documentation and Coding in implementing key strategies to effect change.
Partners with Coding, Clinical Documentation leadership and Medical Directors to coordinate, maintain, and execute advanced project work that includes but, is not limited to, Mortality Review, HAC/PSI Review, Quality Abstraction and Analysis, and/or special and non-traditional project work.
Partners with NM departments that includes but is not limited to: IT; Analytics; and Innovation to design and implement new and advanced workflow solutions.
Partners with third-party consultants/partners to contribute to workflow and methodology build and refine as necessary.