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<ul> <li>Ensure compliant quality coding and abstraction of clinical data. </li><li>Manage CCHC staff and vendors performing inpatient coding and facilitates problem resolution of coding issues. </li><li>Confirm supervisory staff are consistently performing performance-monitoring processes. </li><li>Define, implement, and monitor strategies for improving documentation. </li><li>Develop physician education strategies in conjunction with Clinical Documentation Improvement to promote complete and accurate clinical documentation. </li><li>Develop and report performance measures to the medical staff and other departments of physician specific information regarding documentation compliance. </li><li>Collaborate extensively with physicians, nursing staff and other patient caregivers to improve quality and completeness of documentation of care provided and coded. </li><li>Manage concurrent modifications to clinical documentation to ensure commensurate reimbursement of clinical severity and services rendered to patients. </li><li>Work with the business office to facilitate resolution of coding/billing issues. </li><li>Develop and administer Quality Improvement (QI) and compliance initiatives. </li><li>Monitor discharged not final billed daily accounts receivable and accounts ("DNFB") and any other metrics/benchmarks established by the department. </li><li>Collaborate with other disciplines regarding proposed coding changes and changes needed to address quality concerns; and communicates with the medical staff leadership. </li><li>Coordinate external audits and third party reviews. Conduct exit interviews and implements appeal processes as required. </li><li>Ensure staff address failed claim errors to billing edits, clinical trial codes, and other coding related errors. </li><li>Audit coding and medical record documentation systematically in accordance to National Correct Coding Initiative ("NCCI") and departmental policies and creates and administers policies and procedures to enhance compliance. </li><li>Maintain up-to-date knowledge of regulatory and compliance changes impacting coding requirements and operations, and ensure coding employees are appropriately educated and processes are modified as needed. </li><li>Manage to applicable coding Key Performance Indicators ("KPIs"). Define and implement action plans when performance is not meeting expectations. </li><li>Assess direct reports' performance on a consistent basis and provide feedback to reward effective performance and enable proactive performance improvement steps to be taken. </li><li>Ensure inpatient coding employees and vendor staff are performing coding functions in a manner which complies with established policies, processes and quality assurance programs. </li><li>Support IT in their efforts to test modifications and troubleshoot issues for the 3M Encoder and Soarian Abstracting Systems. </li></ul> <p>Consistently provide service excellence to all patients, family members, visitors, volunteers and co-workers in a manner that reflects Cape Cod Hospital's commitment to CARES: compassion, accountability, respect, excellence and service.</p> <ul> <li>Bachelor's degree required or equivalent combination of education and experience. Master's degree preferred. </li><li>Minimum five years' experience acute care hospital coding and validation required. </li><li>One of the following certifications required: CCS, RHIT, or RHIA. </li><li>Strong knowledge of fiscal intermediary and regulatory agency regulations for coding and hospital reimbursement. </li><li>Progressive experience in inpatient coding and DRG management, including at least one to two years supervisory experience and knowledge of deficiency management practices and experience. </li><li>Thorough knowledge of medical terminology, anatomy and physiology, ICD-10 coding conventions and guidelines, DRG grouping and reimbursement, DRG optimization techniques, data evaluation and analysis. </li><li>An understanding of the psychology of complex corporate relationships, and an ability to influence within such an environment. </li><li>Excellent communication, leadership, delegation, and interpersonal skills. </li><li>Required three to five years of demonstrated experience with health information systems and software applications and knowledge of Soarian financials or comparable software applications. </li><li>Ability to evaluate personal performance against established goals. </li><li>Demonstrated goal-oriented thinking, operational and organizational skills. </li><li>Ability to communicate with and present to a wide variety of CCHC and external users, including senior management and physicians, as well as outside vendors and consultants. </li><li>Ability to work under pressure and manage multiple initiatives concurrently; must be able to work independently, set own priorities and meet deadlines. </li></ul>
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