Clinical Data Manager Out-Patient - Health Information
QUALITY SERVICE SAFETY
We're Healthcare at its Best
The very factors that drive Hackensack University Medical Center to national success are the same ones that drive America's best to us. Employees who value quality, service, and who are energized by career advancement.
Knowledge, Education and Skills Required:
Associates Degree.
Minimum of 5 years experience and thorough knowledge of Case Mix Index, ICD-9-CM, CPT-4, HCPCS and APC methodologies.
Experience and knowledge of DOH, JCAHO, and CMS regulations.
Experience in interpreting LMRPs, billing forms, and knowledge of CDM requirements.
Experience in auditing for quality improvement.
Proficient in computer skills.
Knowledge, Education and Skills Preferred:
Experience with physician reimbursement.
Required Certification/Licensing:
RHIA or RHIT with CCS.
Job Summary:
The Outpatient Clinical Data Manager ensures compliance with applicable documentation, coding, and billing regulations to ensure appropriate reimbursement and stays knowledgeable of all ICD9, CPT, and HCPCs coding changes and guidelines. This position manages and coordinates activities of the outpatient audit and coding staff in Health Information and ambulatory areas.
Essential Generic Job Functions (List in order of importance):
1. Coordinates coding and reimbursement tasks for reduced days in accounts receivable to meet or exceed targeted goals.
2. Responds to inquiries for coding and reimbursement from other departments, and identifies and resolves issues related to coding, denials, and appeals.
3. Reviews APC assignment for Medicare/Medicaid and commercial patients for the purpose of reimbursement, research and statistics in compliance with Federal regulations according to ICD-9-CM, CPT-4, and HCPCS coding classification systems.
4. Coordinates concurrent and retrospective quality audits at least quarterly to ensure compliance with regulatory agencies and reports findings to corporate compliance and other departments as appropriate.
5. Provides and coordinates education sessions for coders and other Medical Center personnel who perform coding tasks.
6. Collaborates with CDM Coordinator and outpatient managers to ensure the CDM and charge tickets/superbills are updated in a timely manner.
7. Oversees the analysis of physician documentation in the medical records for coding compliance.
8. Assists physicians office managers with coding inquiries.
9. Contacts physicians for clarification of documentation of final diagnoses for coding compliance and assists physicians office managers with coding inquiries.
FULL TIME DAYS
Join us by visiting and applying online.
HACKENSACK UNIVERSITY MEDICAL CENTER
When You Feel Good, We Feel Good.
We are an equal opportunity employer offering a smoke free environment.
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