Clinical Documentation Integrity Market Manager

Clark Regional Medical Center

Who We Are:

People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do. Clark Regional Medical Center is a 79 bed community hospital featuring updated technology including new and expanded services such as Diagnostic Services, larger capacity Emergency Services, home-like Labor and Delivery Suites, and a skilled nursing facility. The campus also includes a 45,000 square foot Medical Plaza housing the Clark Clinic, Diagnostic Center for Women, Center for Rehabilitation, Specialty Clinic and Anticoagulation Clinic.

Where We Are:

Winchester offers a truly original experience to all with so much to do and see. Just a short drive from Lexington, the "Horse Capital of the World," and the Red River Gorge, you can experience all the beauty and excitement nature has to offer.

Why Choose Us:

• Health (Medical, Dental, Vision) and 401K Benefits for full-time employees
• Competitive Paid Time Off
• Employee Assistance Program - mental, physical, and financial wellness assistance
• Tuition Reimbursement/Assistance for qualified applicants
• Membership discounts with local gyms and community businesses
• Free Parking
• And much more€¦

Summary:

Manages the Clinical Documentation Integrity program facilitating improvement in the overall quality, completeness, and accuracy of clinical documentation. Through concurrent interaction with physicians, case managers, coders and other health care team members. The Market Manager Clinical Documentation Integrity will strive to ensure comprehensive medical record documentation that reflects the clinical treatment, decisions, and diagnosis for all inpatients. Serving as a resource to all members of the health care team on documentation guidelines, this position will provide guidance and support, as well as assist with education and training related to improving clinical documentation.

Oversees Revenue Integrity Department. Knowledge of appropriate billing being captured, documented, charged, and reimbursed for the assigned departments and facilities in accordance with policies and procedures, and applicable regulatory standards and requirements.

Required Skills:

• Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.

• Must be able to work in a stressful environment and take appropriate action.

Certifications:

• CCDS or CDIP: Preferred

• Coders must have CCS or CIC

License:

• RHIA, RHIT

• Licensed Registered Nurse (RN), Licensed Practical Nurse (LPN)

• Or combination thereof

Essential Functions:

• Conducts daily reviews of inpatient medical records to identify missing, vague, and/or incomplete diagnoses and procedures.

• Conducts timely follow-up reviews of clinical documentation to ensure that issues discussed and queries left in the medical record have been answered by the provider.

• Utilizes coding and clinical expertise to identify opportunities and ensure the accuracy and completeness of clinical documentation used for measuring and reporting physician and hospital outcomes.

• Queries physicians on specificity of procedures performed and diagnoses based on accepted coding guidelines, clinical expertise and LifePoint Hospitals query policy.

• Attends meetings as required.

• Tracks and trends specific opportunities for CDI process improvement through the utilization of metrics reports.

• Conducts educational sessions with physicians and other health care team members on documentation requirements.

• Assumes responsibilities for following compliance guidelines with federal, state, and local regulations within the department.

• Makes regular reports of progress toward goals associated with clinical documentation improvement opportunities and operational improvement plans.

• Is familiar with charge description master (CDM), and/or other pertinent regulations and policies, compliance with all payor requirements, validation reviews and audits.

• Provides validation reviews, audits, documentation and training for the area of knowledge, sharing information with Finance, Health Information Management, and other revenue producing areas or departments.

Functional Demands:

Populations Served

Does not treat or care for patients.

Protected Health Information

Type of Protected Information Accessed:

Demographic

Clinical

Insurance

Financial

Complete Medical Record

Bloodborne Pathogens Exposure

While performing this job, occupational exposure is present for all employees

Physical Requirements - Physical Dexterity and Effort: Rarely

Constantly 67-100%

Bending/Stooping: Occasionally

Climbing: Rarely

Keyboard Data: Constantly

Kneeling: Rarely

Lifting/Moving Patients: Rarely

Reaching: Occasionally

Repetitive Foot/Leg Movements: Rarely

Repetitive Hand/Arm Movements: Constantly

Running: Rarely

Sitting: Rarely

Squatting: Rarely

Standing: Rarely

Walking: Occasionally

Pushing / Pulling: 0-25 lbs.: Occasionally

Pushing / Pulling: 26-75 lbs.: Rarely

Pushing/Pulling: over 75 lbs.: Rarely

Lifting/Carrying (non-patient): 0-25 lbs.: Occasionally

Lifting/Carrying (non-patient) : 26-75 lbs. Rarely

Lifting/Carrying (non-patient) : over 75 lbs. Rarely

Visual Acuity, Hearing and Speaking: Rarely

Audible Speech: Constantly

Hearing Acuity: Constantly

Smelling Acuity: Rarely

Taste Discrimination: Rarely

Vision: Depth Perception: Constantly

Vision: Distinguish Color: Occasionally

Vision: Seeing Far: Occasionally

Vision: Seeing Near: Constantly

Biological: Rarely

Biohazardous waste/ hazards: Occasionally

Blood and/or bodily fluids; Occasionally

Communicable diseases/pathogens: Occasionally

Chemical: Rarely

Asbestos or lead: Rarely

Cytotoxic Chemical: Rarely

Dust: Occasionally

Hazardous Chemicals: Rarely

Gases/Vapors/Fumes: Rarely

Hazardous Medication: Rarely

Latex: Occasionally

EEOC Statement:

Clark Regional Medical Center is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal

Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.