Mgr Clincal Documentation Integrity - Professional Ambulatory

Texas Children's Medical Center • Houston, TX

16h

About The Position

We’re searching for a Manager of Clinical Documentation Integrity of Professional Ambulatory, someone who works well in a fast-paced setting. This position is responsible for developing and carrying out the CDI Review and Education plan for the professional ambulatory services provided at Texas Children's Hospital. The Professional Ambulatory Clinical Documentation Integrity Manager is responsible for communicating documentation and coding regulations, policies, and guideline changes to all applicable parties across the health system and will serve as a documentation and coding subject matter expert for Revenue Integrity departments, physicians, and administration on accurate and ethical coding and documentation standards, guidelines, and regulatory requirements. Conducts and coordinates ongoing educational programs and training for the Hospital on ICD-10 (Internal Classification of Diseases)/CPT (Current Procedural Terminology)/HCPS (Healthcare Common Procedure Coding Systems)/CDPS (Chronic Illness and Disability Payment Systems), and physician coding and billing related updates.

Requirements

• Required bachelor's degree
• Required Licenses/Certifications MDL - Medical Doctor License Texas Medical Board
• RN - Lic-Registered Nurses Texas Board of Nursing or Nursing Licensure Compact
• PA - Cert-Physician Assistant Texas Medical Board
• RHIA - Cert-Reg Health Inform. Admins American Health Information Management Association (AHIMA)
• RHIT - Cert-Reg Health Inform. TECH American Health Information Management Association (AHIMA)
• CCS - Cert-Cert Coding Specialist American Health Information Management Association (AHIMA)
• CPC - Cert-Cert Professional Coder American Academy of Professional Coders (AAPC)
• CCDS DOC - Cert-Cert Clinical Doc. SPCLST Association of Clinical Documentation Improvement Specialist
• CDIP - Cert-Clinical Doc. Impr. PROF American Health Information Management Association (AHIMA)
• CCS-P - Cert-CCS-P Physician Based American Health Information Management Association (AHIMA)
• CIPC - Certified Inpatient Coder American Academy of Professional Coders (AAPC)
• COC - Certified Outpatient Coder American Academy of Professional Coders (AAPC)
• CDEO Certified Documentation Expert Outpatient American Academy of Professional Coders (AAPC)
• CCDS-O Certified Clinical Documentation Specialist Outpatient Association of Clinical Documentation Improvement Specialist
• Required 5 years Progressively responsible and directly related work experience

Responsibilities

• Manages and oversees all professional and ambulatory documentation and coding quality education staff and activities.
• Acts as second level escalation for team members in preparation and delivery of materials, particularly when disagreements of perspective and interpretation occur.
• Develops and provides system wide educational and training program regarding elements of the documentation and coding review program for coding staff and physicians.
• Monitors accuracy and quality of the Professional Ambulatory Clinical Documentation Integrity team, and reports progress to leadership.
• Adapts and updates educational and training program to coincide with regulatory changes.
• Assesses medical record documentation to meet coding compliance and other third-party requirements and identifies documentation trends and issues to bring forward to management, providers and Clinical Documentation Integrity for resolution.
• Applies standardized scoring methodology to consistently evaluate documentation and coding accuracy and standardizes review findings and methodology to report monitoring results.
• Serves as a resource for department managers, staff, physicians, and administration to support accurate and ethical coding and documentation standards.
• Maintains shared location and organization for resources, Q&A, review outcomes, provider feedback, and other content related to the operations of the Professional Ambulatory Clinical Documentation Integrity team.
• Oversees monthly retrospective hospital and professional coding audits and coordinates ongoing monitoring of coding accuracy and documentation adequacy.
• Promotes a culture of continuous improvement through application of methodologies, coaching, mentoring, problem solving tactics, data analysis and development of staff to meet performance expectations.
• Build trust and collaborative relationships with team members, providers, and leaders across the organization.
• Collaborates with other departments in process improvement projects related to Physician’s, APP’s and PB Coding.
• Analyze and interpret data to determine strategic needs related to targeted education/training.
• Oversee certifications and credentialing compliance within team.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager