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Posted: 27-Nov-24
Location: Vail, Colorado
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Internal Number: 5387876004
Vail Health has become the world?s most advanced mountain healthcare system. Vail Health consists of an updated 520,000-square-foot, 56-bed hospital. This state-of-the-art facility provides exceptional care to all of our patients, with the most beautiful views in the area, located centrally in Vail. Learn more about Vail Health here.
Provides clinically based concurrent and retrospective review of inpatient, outpatient and Diversified Clinic medical records to evaluate the utilization and documentation of patient care services. The goal of concurrent review includes facilitation of appropriate physician documentation of care delivered to accurately reflect patient severity of illness and risk of mortality. Specific reviews are both determined internally and by requirements/requests of external payers or regulatory agencies and play a significant role in reporting quality of care outcomes and in obtaining accurate and compliant reimbursement for acute care services.
- Conducts initial and extended-stay concurrent reviews on all selected admissions, and documents findings within CDIS (electronic review system), denoting all key information utilized in the tracking
- Able to utilize inpatient or outpatient admission criteria to assign only diagnoses that meet acute care In the advent that diagnosis does not meet admission criteria, communicates with Case Management Department to determine the appropriate patient status.
- Collaborates with physician, physician extender, nurse, case manager/utilization review and HIM coder to identify principal diagnosis options, secondary diagnoses including complications and comorbidities, and procedures. Assists Case Management with reviewing outpatient surgeries and communicating back surgeries that require inpatient status.
- Identifies need to clarify documentation in medical records, and utilizes strong communication skills with physician, physician extender, case manager, utilization review, nurse or other healthcare professional, utilizing appropriate tools to capture needed documentation.
- Utilizes monitoring tools to track the progress of the outpatient CDI program through interpretation of the CDIS tracking reports, monitoring reports and Able to identify areas of focus through report analysis.
- Assists in the development of query response physician reports. Maintains complete confidentiality of patient information, in addition to hospital and individual physician practice pattern data.
- Provides information and in-services as necessary to physicians and Ancillary Department
- Role models the principles of a Just
- Perform other duties as Must be HIPAA compliant.
Minimum of five (5) years of clinical experience or coding experience in an acute care setting; critical care, medical/surgical or Emergency Department coding.
N/A
- Certified Coding Specialist (CCS) certification by the American Health Information Management Association (AHIMA) required.
- Certified Documentation Improvement Practitioner (CDIP) by the American Health Information Management Association (AHIMA) or
- Certified Clinical Documentation Specialist (CCDS) by the Association of Clinical Documentation Integrity Specialists (ACDIS) preferred.
- Must possess, or be able to obtain within 90 days, the computers skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.
N/A
Benefits at Vail Health (Full Time) Include:
- Competitive Wages & Family Benefits:
- Competitive wages
- Parental leave (4 weeks paid)
- Housing programs
- Childcare reimbursement
- Comprehensive Health Benefits:
- Medical
- Dental
- Vision
- Educational Programs:
- Tuition Assistance
- Existing Student Loan Repayment
- Specialty Certification Reimbursement
- Annual Supplemental Educational Funds
- Paid Time Off:
- Up to five weeks in your first year of employment and continues to grow each year.
- Retirement & Supplemental Insurance:
- 403(b) Retirement plan with immediate matching
- Life insurance
- Short and long-term disability
- Recreation Benefits, Wellness & More:
- Up to $1,000 annual wellbeing reimbursement
- Recreation discounts
- Pet insurance
Pay is based upon relevant education and experience per hour.