Facilitates and obtains appropriate provider documentation for clinical conditions and/or procedures to support the appropriate APR-DRG assignment, severity of illness, expected risk of mortality, and complexity of care provided to patients.
ESSENTIAL FUNCTIONS AND JOB SPECIFIC RESPONSIBILITIES:
Completes initial concurrent reviews of patient records for specified patient populations to evaluate documentation, to assign working DRG, pertinent secondary diagnoses and procedures for accurate APR-DRG assignment, risk of mortality and severity of illness
Educates physicians and providers regarding the need for accurate and complete documentation in the health record.
Partners with coding professionals to ensure accuracy of diagnostic and procedure data and completeness of supporting documentation to determine appropriate APR-DRG assignment
Queries physicians regarding missing, unclear or conflicting health record documentation
Requires experience in own professional discipline to appropriately apply own knowledge; broadens own professional expertise and acquires higher level skills
Understands key business drivers; uses this understanding to accomplish own work
No supervisory responsibilities but may provide informal guidance to new team members
Solves problems in straightforward situations; analyzes possible solutions using professional/technical experience, judgment and precedents
Impacts quality of own work and the work of others on the team; works within guidelines and policies
Receives a moderate level of guidance and direction
Explains complex information to others in straightforward situations
Minimum 1-2 years of job related experience, required
Equivalent combination of education and/or experience in Health Information Management, Healthcare Administration, Healthcare Operations, Coding, Nursing, Case Management, or experience as a Physician, preferred
Four-year Bachelor's degree or equivalent experience, required
Graduate or professional work or advanced degree; or equivalent experience, preferred
LICENSES and CERTIFICATIONS:
Licensed medical doctor, preferred
Licensed registered nurse, preferred
Registered Health Information Management Technician / Administrator, preferred
Light - Exerting up to 20 lbs. occasionally, 10 lbs. frequently, or negligible amounts constantly and may require walking or standing to a significant degree.
I’ve had opportunities to improve my skills and move up in my career. Another way they are helping me to grow is by supporting me through graduate school, supporting my schedule and paying for a portion of my tuition.
Neonatal Intensive Care Unit