Clinical Documentation Integrity Manager

Clinical Documentation Integrity Manager

Job Summary: This professional manages the clinical documentation improvement program and its staff. He/she works with the medical staff and clinical documentation nurse specialists to offer documentation education to secure all legitimate DRG opportunities. He/she works within the scope of care management to provide education and documentation that best represents the patient's clinical findings and treatment plan. This professional is also responsible for coding audits as directed and the management of data quality reviews on specified records, resolution of DRG/APG/ASC coding changes with third party payers. He/she provides structured education programs including ICD10 to physicians and Erlanger staff based on audit findings and prepares and presents required findings and reports.

Education: Required: Must have at least one of the following: RHIA or RHIT or RN with BSN and/or Clinical Coding Specialist (CCS). Maintains professional certification with continuing education credits. Preferred: CCDS or CDIP preferred ICD-10 Certified preferred CS, Masters Degree in Business or health related field

Experience: Required: The candidate must have a strong clinical documentation improvement program background including development, implementation and ongoing management in addition to experience in health information management (minimum of five years) and familiarity with reimbursement principles. Must be computer literate, experienced in use of Microsoft Office and BHIS/SMS/3M systems. The candidate must demonstrate expertise in standard practices in coding/reimbursement and establish the proven ability to optimize payment for all financial schemes. Technical skills include Clinical Documentation and/or Inpatient coding experience with report writing expertise, comprehensive knowledge and proficiency in ICD9-CM, ICD-10 CM/PCS, CPT and HCPCS coding, knowledge of the medical record documentation requirements for ICD-9CM and ICD-10 CM/PCS principles, advanced proficiency in use of Microsoft Office Suite of products including MS Word, Excel and PowerPoint Advanced and Adobe to document and manage audit data. He/she must demonstrate exceptional judgment and organizational ability and possess excellent communication skills, both written and oral. Teaching experience is required. Preferred: Management experience, consulting experience.

Position Requirement(s): License/Certification/Registration Required: Current registration as an RHIT or RHIA or RN and/or CCS Certification. Preferred: ICD 10 Ambassador - certified as a trainer.

Department Position Summary: The manager/educator is responsible for the ongoing management of the clinical documentation program and the assigned staff of specialists, the continuing communication with the medical staff to improve the quality and clarity of documentation of patients' condition in the medical record, the reduction of physician's workload through assistance with regulatory guides through clinical review and the support of documentation of appropriate legitimate diagnoses, MCCs and ccs. The manager/educator also conducts medical record coding audits as required according to assigned time frames. Follow up reports and educational seminars are based on these audit findings. He/she will offer educational seminars to Erlanger staff on a monthly basis or more frequently if necessary. The manager must be organized, able to assimilate large quantities of data, analyze the data and provide organized reports on the data. The manager must be able to demonstrate knowledge of problem identification and resolution. The individual must also demonstrate the ability to review, simplify and teach complex guidelines and optimization techniques. The manager must be able to organize data into a comprehensive educational presentation. The individual must have the professional demeanor needed to present education programs to various audience types. The manager must demonstrate flexibility in the scope and type of work assigned. The manager in this position must display the ability to be self motivated, able to evaluate the scope of each day's work and display time management skills to accomplish the work evaluated. The employee must keep her/his licensure/certification current by participating in continuing education.