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Remote

Manager, Inpatient Coding amp; Clinical Documentation Integrity Services

Ohio State University Wexner Medical Center
United States, Ohio
Feb 12, 2025

Location: Remote

Job Type: Full-time

Are you a dynamic leader passionate about precision, collaboration, and innovation in healthcare? Step into a rewarding opportunity as a Remote Manager of Inpatient Coding and Clinical Documentation Improvement (CDI), where you'll drive excellence in coding accuracy, compliance, and team performanceall from the comfort of your home. If you're ready to inspire a talented team and make a measurable impact on patient care and organizational success, this role is for you.

Scope of Position

The Manager of Inpatient Coding amp; 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 amp; 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 amp; Clinical Documentation Integrity Servicesworks 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 amp; 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. Also, the manager of inpatient coding keeps detailed records of all audits conducted, the results, recommendations, and follow-up to assure action is taken. The manager develops training materials and conducts training sessions with the coding quality analysts, coders, and students. The leader of this team must constantly interact with Department Administration, Department Managers, medical staff, medical staff secretaries, medical and nursing students, nursing, and unit clerical associates.

The purpose of the clinical documentation integrity program is to ensure quality patient care is documented in the medical record. The documentation in the medical record reflects the accuracy of coding and Medicare Severity Diagnosis Related Group (MS-DRG)/All Patient Refined Diagnosis Related Groups (APR-DRG) assignment. Clinical Documentation Integrity specialists validate present on admission indicators and coding of diagnoses that influence the severity of illness and risk of mortality scores. Clinical Documentation Integrity Specialists serve as partners to the clinical and business departments of the health system and is used to support patient care, patient safety, teaching, research, hospital operations, quality assurance, and reimbursement.

Minimum Qualifications

For Hire:

Education:

  • Required:
    • Bachelors degree in Health Information Management (HIM), Nursing, or a related healthcare field.
  • Preferred:
    • Masters degree in Health Information, Business Administration, Public Health, or Healthcare Leadership.
    • Advanced education or coursework in healthcare analytics, data science, or informatics to align with academic medical center needs.

Candidate must possess one of the following certifications:

  • Certified Coding Specialist (CCS) through AHIMA or equivalent credential.
  • RHIA (Registered Health Information Administrator) or RHIT (Registered Health Information Technician) through AHIMA.

Experience

Required:

  • 7 years of relevant experience required. 12 or more years of relevant experience preferred.
  • 2+ years of leadership or supervisory experience in coding, HIM, or CDI.
  • Demonstrated knowledge of MS-DRGs, ICD-10-CM/PCS, and compliance regulations (e.g., Medicare, Medicaid, Joint Commission).
  • Proven experience with electronic health record (EHR) systems, such as Epic or Cerner, and coding software.

Preferred:

  • Previous experience working with CDI teams or managing CDI programs.
  • Experience with quality improvement initiatives related to coding accuracy and documentation.

Skills:

  • Strong understanding of clinical documentation improvement concepts and their impact on reimbursement and quality metrics.
  • Deep knowledge of coding guidelines, regulatory requirements, and compliance policies (e.g., CMS, OIG).
  • Proficiency in auditing and monitoring coding accuracy and documentation quality.
  • Excellent leadership, team-building, and communication skills to manage multidisciplinary teams (e.g., coders, CDI specialists, and physicians).
  • Analytical and problem-solving skills to address complex coding/documentation issues and trends.
  • Familiarity with data analysis tools for coding productivity and quality (e.g., Excel, Tableau, or similar platforms).
  • Education and Training: Proven ability to develop and deliver coding and CDI education tailored to providers, coding/CDI teams, and senior leadership, including one-on-one coaching for providers and workshops for diverse audiences.
  • Communication with Leadership: Skilled in preparing data-driven presentations and reports for senior leaders, using tools like Tableau and Excel to present actionable insights on compliance, financial impacts, and quality metrics.
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