Manager Coding Data Quality-AdventHealth Medical Group
All the benefits and perks you need for you and your family:
·Benefits from Day One
·Paid Days Off from Day One
·Student Loan Repayment Program
·Career Development
Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Schedule: M-F
Shift: 8AM-5PM
Location: 900 Hope Way, Altamonte Springs
The community you’ll be caring for:
·More than 800 physicians, 450 advanced practice providers, and 2,600 clinical and support staff in over 40 specialties, provide patients with a broad range of medical and surgical services.
·AdventHealth Medical Group Central FL operates over 200 offices, providing compassionate, multidisciplinary care to more than one million patients a year.
·In existence since 1994, AdventHealth Medical Group Central FL has demonstrated consistent growth and stability in an ever-changing health care market.
The role you’ll contribute:
The Manager Coding Data Quality has direct oversight for the inpatient and/or outpatient coding auditors and ensuring integrity of coded data. Responsible for reviewing medical records and coding diseases and operations in accordance with the requirements of the ICD-10-CM coding conventions and the requirements of Medicare Prospective Payment System. Reviews documentation for Agency for Healthcare Research and Quality (AHRQ) quality measures, billing activities and for retrieval of medical and statistical information for research and management purposes. Adheres to the AdventHealth policies and procedures while ensuring the adherence to all rules and regulations of all applicable local, state and federal agencies and accrediting bodies. Maintains the confidentiality of employees, patients, administrative staff and functions, and medical staff information with no infractions. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
The value you’ll bring to the team:
·Manages, develops and coaches inpatient and/or outpatient coding auditors, motivating and supporting others in overcoming barriers to understanding.
·Reviews medical record documentation and coded data for AHRQ quality indicators, ensuring
accurate quality measurement and reporting.
·Collaborates with Clinical Documentation Integrity (CDI) to review variances and establish criteria/guidelines for improved documentation consistent with clinical definitions and compliant with coding regulations.
·If applicable - When working within Risk Adjustment will manage all audit work related to coding validation audits as well as audits performed by any other entity, creating compelling responses to all Risk Adjustment discrepancies by providing information from the clinical record and referencing coding rules and guidelines.
·Serves as a subject matter expert on the interpretation and application of coding rules and regulations.
·Researches, abstracts and educates various stakeholders on federal, state and payer documentation
and coding rules and regulations.
·Conducts periodic assessment of coding quality program, providing suggestions for improvement based on regulatory compliance and organizational needs.
·Assists senior management with external and post payment audits, helping to develop and create
compelling responses to Diagnostic Related Groups (DRG) discrepancies by providing information from the clinical record and referencing coding rules and guidelines.
·Uses critical thinking and sound judgement in decision making keeping reimbursement considerations
in balance with regulatory compliance.
·Assumes personal responsibility for professional growth, development and continuing education to
maintain a high level of proficiency.
·Performs other duties as assigned.
The expertise and experiences you’ll need to succeed:
Minimum qualifications:
Five years of inpatient and/or outpatient coding experience in an acute-care hospital setting
RHIA, RHIT or CCS certification or credential
Preferred qualifications:
oFive years of experience in Risk Adjustment with cases involving a more complex level of coding.
oProgressive professional growth
oPrevious coding management experience
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.