At Shire, we are proud and grateful to employ military veterans and thank them for their contributions to our company and our country. See where your military experience can play a role at Shire by using our military skills translator job search tool below:
71477BR
Auto req ID:
71477BR
Department:
24003 - KH Corp Health Inform Systems
Job Description:
The Coding Quality Coordinator (CQC) professionals ensures accurate coding and data collection for reimbursement. They strive to promote an accurate and meaningful databases best represents resources used in patient care. The CQC acts as an essential resource working collaboratively with Coding Specialists, Physicians/Providers, Clinical Document Specialists, Quality Department, Nursing, Patient Management, Patient Financial Services, Corporate Compliance, Clinics, and Ancillary depts to perform and review the coding and DRG assignment for accuracy. Serves as the liaison between coding specialists and clinical documentation specialists for DRG Mismatch and reconciliation of case variation. Ensures all inpatient and outpatient diagnoses, procedures and data collection accurately reflects the appropriate case mix index, severity of illness, expected risk of mortality, the complexity of patient care and use of resources. Ensures accurate data collection for the NYSDOH Statewide Planning and Cooperative System that is used for planning and financial rate setting. Plan and execute audits for the quality of coded data to best represent the case mix, the accurate Diagnosis Related Group (DRG) assignment, proper reimbursement and quality measure/metrics. Assists with the audit analysis, trending, and presentation of audit/review findings, potential issues and identifies opportunities for education. Specific to Outpatient and Emergency Department coding arena, the CQC must ensure the appropriate CPT procedure coding, modifiers, Evaluation and Management (E&M) coding, and charges are correct. Ensures identification of trauma registry cases and compliance with applied charges. Demonstrate a high proficiency of the coding systems, data collection, coding conventions and guidelines, clinical conditions, diagnosis and procedures. Utilize coding proficiency to plan and execute quality audits, perform data analysis, trending, presentation of audit/review findings, and identify opportunities and develop a training plan for the coding specialist. Participates in a variety of other departmental quality audits that may be used to support quality measures reporting. Reports results of coding audits, researches coding materials and recommends educational programs.
Buffalo, NY
Location:
Larkin Bldg @ Exchange Street
Recruiter:
Amanda Miller
Minimum or Preferred Qualifications:
AAS - Associate of Applied Science in Health Information Technology or Medical Record Technology required. Bachelor of Science in Health Information Management, Medical Record Administration, Nursing, Health care Administration or similar preferred. 3 years acute care facility coding. 3 Years extensive knowledge of coding classification systems to include but not limited to ICD10 and/or CPT coding, AP-DRG, APR-DRG, MS-DRG assignment in an acute care facility. Present on admission guidelines, secondary diagnoses classification for MCCs/CCs, MDCs, APR DRG grouper, SOI, and ROM scores, MS DRGs, E/M leveling required. 2 years of experience in Quality Assurance/Audit skill set with inpatient/or outpatient including Evaluation and Management coding/or Interventional Radiology required. 2 years of experience in Analytical thinking, problem solving, verbal and written communication. Ability to work independently and diligently meet deadlines required. 2 years of experience in Acquired Conditions, Patient Safety Indicators, and CMS Core Measures preferred. 2 years of experience with Microsoft Office (Excel, Word), Internet, Encoder, Grouping software and Federal, state, and private payer regulations and health care reform as it relates to changes in chart review preferred. Reg Health Info Tech (RHIT) and Reg Health Info Admin (RHIA)required upon hire. Certified Coding Specialist (CCS) through AHIMA is preferred. Candidates must take and successfully pass a Kaleida Health coding test.
Status:
Full Time
Shift:
Days
Scheduled Work Hours:
7a-3p; 7:30a-3:30p; 8a-4p; 8:30a-4:30p; 9a-5p
Salary Range:
$56,891-$87,067 annually Wage will be determined based on factors such as candidate's experience, qualifications, internal equity, and any applicable collective bargaining agreement.
Grade:
11
Position:
Coding Quality Coordinator
Union Code:
00 - Non Union
Bi-Weekly Hours:
75
Weekend/ Holiday Requirement:
No Weekends or Holidays Required
Equal Opportunity Employer
Kaleida Health is committed to diversity and believes our workforce is strengthened by the inclusion of and respect for our differences.
Kaleida Health is an equal opportunity and affirmative action employer. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, religion, sex, national origin, citizenship status, creed, gender, gender identity or expression, sexual orientation, disability, veteran status or any other factor which cannot lawfully be used as a basis for an employment decision.
Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for or perform your job.