Manager, Inpatient Coding & Clinical Documentation Integrity Services

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Job Title:

Manager, Inpatient Coding & Clinical Documentation Integrity Services

Department:

Health System Shared Services | MIM CDI and Coding

HYBRID ROLE

Scope of Position

 

The Manager of Inpatient Coding & Clinical Documentation Integrity Services is responsible for managing systems and operations for efficient coding of inpatient medical record information from University Hospital. East Hospital, Brain and Spine Hospital, James Hospital, Ross Heart Hospital, Harding Hospital, Talbot Hall, and Dodd Hall. The manager monitors ICD-10-CM/PCS code assignments and data entry for inpatient and rehabilitation prospective payment systems (MS-DRGs and APR-DRGs). Monitors computerized medical record information systems, i.e., IHIS and 3M Encoder.  In this role, the Inpatient Coding & Clinical Documentation Services Manager serves as a liaison and coordinator for special projects regarding the coding of medical records.

 

This position is critical to the financial standing of the hospital. Under the prospective payment system, the accuracy of the coding of diagnoses and procedures and the timeliness of their provision to the billing system will determine if the hospital will receive the full and proper payment from Medicare, Medicaid, CHAMPUS, and other third-party payers.

 

This position is critical to the reputation of the hospital. The hospital is obligated to report accurate codes reflecting physician documentation for billing purposes. The Manager trains coders and monitors coders' performance to assure accurate and compliant coding.

 

The Manager of Inpatient Coding & Clinical Documentation Integrity Services works to strategically plan, organize, implement and re-evaluating processes to keep staff engaged and to assist in meeting department and organizational goals for the documentation integrity program at OSUWMC. This includes ensuring the documentation in the medical supports the case mix index (CMI), severity of illness (SOI), risk of mortality (ROM), hierarchical coding categories (HCC) as well as quality initiatives such as patient quality indicators (PSI) and hospital acquired conditions (HAC).

 

To achieve these goals and financial metrics, the manager works in collaboration with various health system operational leaders. 

 

 

Position Summary

 

This role serves as the manager for inpatient coding & clinical documentation integrity services. This team is vital to the continued operation of the entire department as it serves to assign the codes necessary for the billing of the inpatient accounts.  The manager sets forth daily priorities for staff, monitors accounts that are not resolved, and makes suggestions for change to the Director of Coding, CDI, and Compliance. They support coding specialists in assigning ICD-10-CM/PCS diagnoses and procedure codes. They also determine Medicare Severity Diagnosis Related Group (MS-DRG) and All Patient Refined Diagnosis Related Groups (APR-DRG) for billing and statistical purposes. The manager monitors performance to assure compliance with policies and procedures and billing rules