UnityPoint Health Health Information Integrity Specialist in Des Moines, Iowa
The Health Information Integrity Specialist position is to review the documentation and coding practices to identify trends and revenue cycle opportunities for the organization. To analyze the root causes of documentation and coding variations and how they impact the quality of care, hospital case mix index, and reimbursement. Communicate the findings and recommendations to management and key stakeholders to minimize the risks and to develop appropriate action plan(s) to obtain favorable outcomes based on the supported documentation from the medical records.
Perform chart audits to investigate the reporting data from internal and external sources to validate organizational performance.
Audit the medical records to review provider documentation and coding information to identify trends and opportunities.
Use audit results to recommend areas of focus for educational purposes, in-service training, initiate processes changes, and to reduce organizational risks.
Interacts and engages in discussions with physicians and other clinicians regarding documentation deficiencies and opportunities to provide complete and accurate documentation.
Trained in ICD-10-CM/PCS
Requires a minimum of three years coding experience in an acute care setting.
A minimum of three (3) years of experience of understanding and applying ICD CM/PCS coding guidelines and conventions, Uniform Hospital Discharge Data Set (UHDDS) reporting requirements, and the Diagnosis Related Group (DRG) methodology.
Requires working knowledge MS-DRG/APC reimbursement expertise and current issues on medical coding, compliance and reimbursement.
Previous experience in clinical documentation improvement is preferred.
Requires one or more of the following certifications: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), or Certified Professional Coder (CPC). Must be active.
Certified Clinical Documentation Specialist/Professional (CCDS/CDIP) is preferred.
Requires knowledge of the regulatory and compliance practices such as Uniform Hospital Discharge Data Set (UHDDS) reporting and rules for CMS-DRG, MS-DRG and APR-DRG assignment, HIPAA, AHIMA Guidelines for Compliance Query Writing.
Be able to collect, interpret and evaluate narrative and statistical data pertaining to audit outcomes; prepare complex reports, memoranda and other written materials.
Understand how clinical documentation affects the quality of care and financial outcomes.
Broad based clinical understanding (i.e. Medical terminology, including pathophysiology and complex disease processes, conditions and treatments).
Must be able to read, write and speak fluent English; ability to write clear and concise, grammatically correct notes and business correspondence without supervision.
Requisition ID: 2018-49701
Street: 1200 Pleasant St
Name: 3020 UnityPoint Health Des Moines
Name: HIM- CDI
FLSA Status: Exempt
Scheduled Hours/Shift: Full Time; Monday - Friday Days
External Company URL: http://www.unitypoint.org