University of Utah Job Description
Job Summary
Perform extensive clinical documentation and data analysis. Recommend clinical documentation improvement suggestions to the providers in an effort to increase the specificity of their clinical diagnoses and procedures thus, optimizing revenue for the facility and providers and accurately reflecting patient acuity for the organization. Coordinate education, training, and support related to faculty, students and employees, regarding clinical documentation improvement recommendations. Collaborate with providers, managers, and staff to assist departments, clinics, and/or service lines in implementing, coordinating and monitoring documentation best practices.
Qualifications
Bachelor’s degree or equivalent experience required. Master’s Degree in a related field preferred. Six to eight years progressive professional, outpatient, and/or inpatient coding experience in a multispecialty setting. Current credentials as an RHIA, RHIT, CCS, CPC, or current Registered RN, CDIP, or CCDS.
Knowledge of concurrent review/clinical documentation improvement process. Thorough knowledge of CMS and other applicable guidelines and regulations. Knowledge of Medicare Part A and B, and how they impact DRG assignment (ICD-9 and ICD-10). Ability to analyze patient chart information for accuracy and completeness. Excellent command of the ICD-9-CM/PCS, ICD-10-CM/PCS and CPT-4 classification systems, with a thorough understanding of the effect it has on data quality for prospective payment, utilization and reimbursement.
Analytical skills necessary to interpret, prepare, and analyze data. Knowledge and ability to ensure and promote consistent, quality-oriented documentation best practices. Ability to adapt, and help others understand and accept values, strategies, goals and plans in response to changing business conditions. Flexible, positive, clear interpersonal and communication skills, with the ability to facilitate the exchange of information within all levels of UUHC.
Critical thinking, problem solving and deductive reasoning skills. Proficient in Excel, Word, and PowerPoint, and the ability to independently produce documents. Excellent organizational, analytical, writing and interpersonal skills. Demonstrate effective verbal and written communication skills.
This position has no responsibility for providing care to patients.
Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description.
Disclaimer
This job description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the job.
Essential Functions
1. Works with providers to ensure the appropriate specificity is in the documentation of their clinical diagnosis and procedures to optimize revenue and accurately reflect patient acuity.
2. Develops and manages workflows and tasks related to clinical documentation improvement.
3. Identifies and addresses current documentation gaps to minimize potential revenue losses and identify potential revenue opportunities. Reviews and analyzes data accordingly.
4. Acquires and stores accurate data in a computer database, for subsequent retrieval, to provide dependable analysis and reporting.
5. Plans, compiles, analyzes and produces data reports to facilitate reporting requirements and decisions necessitating analytical input.
6. Coordinates the planning and design of data reporting forms and formats, to establish data record systems and documents.
7. Oversees consultants in the auditing of charts.
8. Coordinates education, training and support related to faculty, students and employees, regarding clinical documentation improvement recommendations.
9. Collaborates with providers, managers and staff to assist departments, clinics, and/or service lines in implementing, coordinating, and monitoring documentation best practices.
10. Ensures providers and the institution are ready for ICD-10. Serves as an expert resource in ICD-10-CM/PCS.
11. Utilizes creative problem-solving techniques.
Comments
Work Environment and Level of Frequency typically required
Nearly Continuously: Office environment.
Physical Requirements and Level of Frequency that may be required
Nearly Continuously: Sitting, hearing, listening, talking.
Often: Repetitive hand motion (such as typing), walking.
Seldom: Bending, reaching overhead.
