Voca Professional has immediate openings available for Coding Quality Specialist-CDI professionals in Rochester,MN!
Voca connects healthcare professionals with fantastic health systems nationwide. Our goal is full partnership with our employees, providing the tools, guidance, and opportunities to help reach their individual goals. Voca provides benefits including insurance, 401k, and dedicated support!
Assignment details are provided below, we’re very excited to hear from you!
- The CDI/Coding Quality Specialist works collaboratively as a subject matter expert to the Enterprise Operations Administrator providing assistance based on the vision, mission, philosophy and core values of our client through various projects ensuring appropriate clinical documentation/coding measures are present, along with ensuring quality metrics are being utilized.
- The CDI/Coding Quality Specialist assures compliance with external and internal measures for the CDI Program, assisting in review of reports such as PEPPER, CMI benchmarking, and other pertinent regulatory data.
- The CDI/Coding Quality Specialist identifies areas of improvement for the CDI program ensuring quality work is being performed.
- The CDI/Coding Quality Specialist will work to identify and share updates related to Coding Guidelines, OIG updates and AHA Coding Clinic changes (Annual/Quarterly) as they relate to Clinical Documentation Integrity.
- Additionally, the CDI/Coding Quality specialist will participate in reviewing, researching and identifying trends and opportunities of DRG changes/denials..
- May be asked to assist in development of teaching tools for both physicians and CDI staff members and perform pre-bill retrospective chart review on focus projects.
- Must be self-motivated and able to work as part of a team with minimal supervision. Must possess the ability to work well within a creative and challenging work environment.
- This position is an exempt position and will be located in Arizona and has a telecommute option with a minimum of 10% travel required at the discretion of
- Enterprise Operations Administrator CDI.
- Must demonstrate proficiency in ICD-10 CM/PCS, ICD-9-CM, MS-DRG methodology, APR-DRG methodology, Clinical Validation, CPT, HCPCS, HCCs.
- Must demonstrate proficiency of IPPS and OPPS subject matter.
- Must demonstrate an understanding of HACs, PSIs,
- A Bachelor's Degree is required with at least five years' experience in
- Revenue Cycle leadership with supervisory and project management experience.
- Five years in-patient coding and DRG auditing along with two years' experience in CDI is required.
- In-Patient Coding Certification (CCS through AHIMA) and Outpatient Coding Certificate(s) (CPC and/or COC through AAPC) as well as CDI Certification (CCDS through ACDIS or CDIP through AHIMA) is required.
- At least 1 year of external payer auditing required. Experience in developing in-patient teaching tools (including developing compliant CDI physician queries) for physicians/NP/PA's/Coding/CDI staff required.
- Minimum of three years of experience related to DRG denials is required.
- Excellent communication, problem-solving and decision-making skills along with relevant experience including lead roles, project/committee leadership, and experience educating physicians, nurses and other staff principles of Coding and CDI is required.
- Core Measures, Mortality Reviews and other Quality measures as
related to CDI and Coding.
- Experience in Revenue Cycle Leadership and CDI program Leadership.
- Experience in data analytics in order to identify trends and opportunities.
- Computer experience in Microsoft Office applications such as Word, Excel, Powerpoint.
- Previous experience with external accrediting bodies (e.g., NCQA, JCAHO) helpful. Knowledge of Medicare and Medicaid guidelines and understanding of managed care and commercial review experience preferred.
- Experience in developing and implementing new processes, services, or business lines preferred.
- One year external payer auditing required; preferably with CMS In-patient auditing (Recovery Audit Contractor Auditing and/or Clinical Validation auditing.
Partnering with Voca comes with a number of benefits including:
- Dedicated Recruiter
- Competitive, Flexible Pay Packages
Voca: The Spirit of Work