We're searching for a Manager of Clinical Documentation Integrity of Professional Ambulatory, someone who works well in a fast-paced setting. This position is responsible for developing and carrying out the CDI Review and Education plan for the professional ambulatory services provided at Texas Children''s Hospital. The Professional Ambulatory Clinical Documentation Integrity Manager is responsible for communicating documentation and coding regulations, policies, and guideline changes to all applicable parties across the health system and will serve as a documentation and coding subject matter expert for Revenue Integrity departments, physicians, and administration on accurate and ethical coding and documentation standards, guidelines, and regulatory requirements. Conducts and coordinates ongoing educational programs and training for the Hospital on ICD-10 (Internal Classification of Diseases)/CPT (Current Procedural Terminology)/HCPS (Healthcare Common Procedure Coding Systems)/CDPS (Chronic Illness and Disability Payment Systems), and physician coding and billing related updates.
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Job Duties & Responsibilities
Manages and oversees all professional and ambulatory documentation and coding quality education staff and activities.
Acts as second level escalation for team members in preparation and delivery of materials, particularly when disagreements of perspective and interpretation occur.
Develops and provides system wide educational and training program regarding elements of the documentation and coding review program for coding staff and physicians. Monitors accuracy and quality of the Professional Ambulatory Clinical Documentation Integrity team, and reports progress to leadership.
Adapts and updates educational and training program to coincide with regulatory changes.
Assesses medical record documentation to meet coding compliance and other third-party requirements and identifies documentation trends and issues to bring forward to management, providers and Clinical Documentation Integrity for resolution. Applies standardized scoring methodology to consistently evaluate documentation and coding accuracy and standardizes review findings and methodology to report monitoring results.
Serves as a resource for department managers, staff, physicians, and administration to support accurate and ethical coding and documentation standards.
Maintains shared location and organization for resources, Q&A, review outcomes, provider feedback, and other content related to the operations of the Professional Ambulatory Clinical Documentation Integrity team.
Oversees monthly retrospective hospital and professional coding audits and coordinates ongoing monitoring of coding accuracy and documentation adequacy.
Promotes a culture of continuous improvement through application of methodologies, coaching, mentoring, problem solving tactics, data analysis and development of staff to meet performance expectations.
Build trust and collaborative relationships with team members, providers, and leaders across the organization.
Collaborates with other departments in process improvement projects related to Physician's, APP's and PB Coding.
Analyze and interpret data to determine strategic needs related to targeted education/training.
Oversee certifications and credentialing compliance within team.
Skills & Requirements
Required bachelor''s degree
Required Licenses/Certifications
MDL - Medical Doctor License Texas Medical Board
RN - Lic-Registered Nurses Texas Board of Nursing or Nursing Licensure Compact
PA - Cert-Physician Assistant Texas Medical Board
RHIA - Cert-Reg Health Inform. Admins American Health Information Management Association (AHIMA)
RHIT - Cert-Reg Health Inform. TECH American Health Information Management Association (AHIMA)
CCS - Cert-Cert Coding Specialist American Health Information Management Association (AHIMA)
CPC - Cert-Cert Professional Coder American Academy of Professional Coders (AAPC)
CCDS DOC - Cert-Cert Clinical Doc. SPCLST Association of Clinical Documentation Improvement Specialist
CDIP - Cert-Clinical Doc. Impr. PROF American Health Information Management Association (AHIMA)
CCS-P - Cert-CCS-P Physician Based American Health Information Management Association (AHIMA)
CIPC - Certified Inpatient Coder American Academy of Professional Coders (AAPC)
COC - Certified Outpatient Coder American Academy of Professional Coders (AAPC)
CDEO Certified Documentation Expert Outpatient American Academy of Professional Coders (AAPC)
CCDS-O Certified Clinical Documentation Specialist Outpatient Association of Clinical Documentation Improvement Specialist
Required 5 years Progressively responsible and directly related work experience
Since 1954, Texas Children's has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children's hospital in Texas, and among the top in the nation by U.S. News & World Report as well as recognition from Houston Business Journal as one of this city's Best Places to Work for ten consecutive years.
Texas Children's comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Tower for pediatric research; Texas Children's Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children's Hospital West Campus, a community hospital in suburban West Houston; Texas Children's Hospital The Woodlands, the first hospital devoted to children's care for communities north of Houston; and Texas Children's Hospital North Austin, the new state-of-the-art facility providing world-class pediatric and maternal care to Austin and Central Texas families. We have also created Texas Children's Health Plan, the nation's first HMO focused on children; Texas Children's Pediatrics, the largest pediatric primary care network in the country; Texas Children's Urgent Care clinics that specialize in after-hours care tailored specifically for children; and a global health program that is channeling care to children and women all over the world. Texas Children's Hospital is affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation.
To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities.
Texas Children's is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children''s without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.