Coding Quality Auditor and Specialist, HB Coding, Full-time, Days (Remote - Must reside in IL, IN, IA, WI, OH, MO, MI, or FL) position at Northwestern Medicine.| United States

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Northwestern Medicine Coding Quality Auditor and Specialist, HB Coding, Full-time, Days (Remote - Must reside in IL, IN, IA, WI, OH, MO, MI, or FL)

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Job DescriptionThe Coding Quality Auditor and Specialist reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. The Coding Quality Auditor and Specialist is required to be the expert in the work related to clinical documentation and coding. This position works in tandem with the Clinical Documentation Team assuring quality metrics are held to the highest standard for NM Health System.The Coding Quality Auditor and Specialist is responsible for assuring coding guidelines and regulations are not compromised during the decision-making process related to clinical documentation and the coding of this documentation. This position partners with Clinical Documentation Nurses, Physicians, and other licensed providers to improve the quality of documentation, assuring best quality performance and representation of care provided. In addition, the Coding Quality Auditor and Specialist collaborates with the CMOs to ensure the integrity of the Health Record is established through best practices in Clinical Documentation and Coding.The Coding Quality Auditor and Specialist is responsible for maintaining quality work queues and quality reports, advanced and complex project work that includes, but is not limited to, Risk Adjustment, Mortality Review, Hospital Acquired Condition (HAC) and Patient Safety Indicator (PSI) Review, Quality Abstraction and Analysis, and/or special and non-traditional project work. Incumbents to this role have a mastery of advanced clinical documentation integrity and quality concepts, coupled with the ability to consistently identify root causes and deliver measurable results. Key to this role is the ability to lead and facilitate quality initiatives and external rankings initiatives while remaining compliant within the coding guidelines and regulations.The Coding Quality Auditor and Specialist solves complex problems and adds new perspectives to existing solutions. The Coding Quality Auditor and Specialist applies advanced knowledge of the national quality agenda and clinical documentation integrity and coding compliance to advance problem analysis and creative process redesign for Northwestern Medicine. This position is 100% remote (occasional onsite meeting attendance may be requested)Responsibilities:Collaborates with clinical documentation team in the review of inpatient accounts (with an emphasis on mortality reviews) identifying documentation improvement opportunitiesAssess DRG, PDx, secondary Dx, PCS, POA and all other components of documentation that impact quality metricsConsistently assures coding practices remain compliant with coding guidelines and regulationsContinually identifies educational opportunities related to coding and documentationExpert educator to clinical teams and medical staffIdentifies strategic plans that will result in a positive impact to the clinical dashboardDevelops clinical relationships across the health system securing interdepartmental support necessary for successful implementation of education strategies assuring achievement of overall strategic targetsAbility to multi-task a variety of auditsAbility to analyze data and construct appropriate action plansDevelops teaching tools to promote quality outcomesIs an active member of clinical and executive meetings as identifiedAdvanced understanding of quality metrics for health system (Vizient, PSI, USNWR)Advanced understanding of clinical documentation and coding through the lens of local and national quality and ranking methodologies, including but not limited to, U.S News and World Report, Vizient, Leapfrog, the CMS Star Rating, and payer contracts and assists the Managers of Clinical Documentation and Coding in implementing key strategies to effect change.Partners with Coding, Clinical Documentation leadership and Medical Directors to coordinate, maintain, and execute advanced project work that includes but, is not limited to, Mortality Review, HAC/PSI Review, Quality Abstraction and Analysis, and/or special and non-traditional project work.Partners with NM departments that includes but is not limited to: IT; Analytics; and Innovation to design and implement new and advanced workflow solutions.Partners with third-party consultants/partners to contribute to workflow and methodology build and refine as necessary.

Coding Quality Auditor and Specialist, HB Coding, Full-time, Days (Remote - Must reside in IL, IN, IA, WI, OH, MO, MI, or FL) job opportunity at Northwestern Medicine.

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