Supervisor Clinical & Coding Quality

UT Southwestern Medical Center • Dallas, TX

1d • Remote

About The Position

The Clinical and Coding Quality Supervisor provides direct operational leadership and subject matter oversight for all daily clinical and coding quality workflows and assignments. This role is responsible for ensuring the accuracy, consistency, and effectiveness of second-level coding quality review workflows that support risk adjustment, DRG integrity, regulatory compliance, and institutional quality and financial performance. Promote and support Teamwork and engagement, performance excellence, accountability and professionalism. Lead and support process improvement. Ensure the Clinical & Coding Quality Team have the education and tools they need to successfully perform to the highest levels of quality and compliance.

Requirements

• Bachelor's degree in nursing
• 3 years of experience working in an Acute Hospital setting preferably in an Academic environment.
• 3 years to 5 years' experience working in a Quality/Risk Program.
• Experience utilizing methodology-specific risk calculators and guidance documents to understand if additional diagnoses and/or risk variables will impact the reported quality impact of a specific patient encounter and
• Experience working in a remote environment
• (RN) REGISTERED NURSE Upon Hire and
• (CCDS) Cert Clinical Documentation Upon Hire and
• AHIMA Certified Coding Specialist (CCS) within 1 Year or
• AAPC Certified Inpatient Coder (CIC) within 1 Year

Responsibilities

• Manages staffing and all employee related duties.
• Provide day-to-day supervision of Coding Quality Analysts, including work assignment, prioritization, performance monitoring, and issue resolution.
• Oversee all quality workflow and assignments:
• Ensure quality changes are completed within revenue cycle goals and corrections are completed within deadlines.
• Serve as the primary escalation point for complex CDI, coding, DRG, and risk-adjustment questions requiring advanced review.
• Oversee coding quality audits validating ICD-10-CM/PCS code assignment accuracy, abstracted data accuracy (POA, discharge disposition, point of origin, admit type, PSI‿s), completion and implementation of coding audit recommendations across systems (Epic, 3M, eValuator) and ensure audit findings and recommendations are accurately implemented in final coded data sets.
• Track, trend, and report quality metrics, including error rates, rework, and risk-adjustment performance (Vizient, HCC‿s, Elixhauser) to Leadership (Direct Manager, Coding and Quality Director, Coding and CDI Managers, Physician Advisors, etc.)
• Identify front-end workflow issues impacting coding quality and recommend process improvements, deliver targeted education based on audit outcomes.
• Collaborate with Denials Team processes and initiatives.
• Maintains an expert level of knowledge of Coding, CDI, Denials, and Appeal guidelines and practices.
• On-boards, trains, and audits new Coding Quality Analysts.
• Support the Quality Standards set by UTSW & the Coding Quality & Integrity Department.
• Other duties as assigned.

Benefits

• PPO medical plan, available day one at no cost for full-time employee-only coverage
• 100%25 coverage for preventive healthcare-no copay
• Paid Time Off, available day one
• Retirement Programs through the Teacher Retirement System of Texas (TRS)
• Paid Parental Leave Benefit
• Wellness programs
• Tuition Reimbursement
• Public Service Loan Forgiveness (PSLF) Qualified Employer

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 5,001-10,000 employees