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Supervisor, Outpatient Clinical Documentation Integrity
Lehigh Valley Health Network. Oversees the daily operations of the RA Coding Team across a multi-facility, integrated healthcare delivery system.
About the role
Key responsibilities & impact- Oversees the daily operations of the RA Coding Team across a multi-facility, integrated healthcare delivery system.
- Supervises workflow, scheduling, and LVHN provider education efforts related to physician-based and ambulatory service documentation and coding, clinical quality measures, value-based reporting, and risk adjustment coding principles.
- Monitors daily operations to ensure the completeness of the medical record and compliance in coding, quality, and risk adjustment for physician-based and ambulatory services.
- Ensures departmental operations align with network initiatives and departmental goals.
- Incorporates performance and process improvement tools, resources, and processes for optimal efficiency, effectiveness, and responsiveness to changes in guidelines.
- Analyzes coding trends/issues and provides recommendations for process changes to improve RA CDI and coding workflow and outcomes.
- Leads and supervises daily workflow to ensure adequate coverage and staffing.
- Participates in hiring, onboarding, and ongoing evaluation of performance.
- Tracks and trends performance data for team members, provider compliance, and abstraction outcomes.
- Produces reporting and analytics and presents to leadership.
- Promotes accountability at all staff levels through coaching, training and education, performance monitoring, consistent feedback, commendations, and disciplinary action plans.
- Ensures that knowledge of risk adjustment models, pro fee coding guidelines, regulatory requirements, and additional relevant rules remain current as changes occur.
- Ensures compliance of all provider notifications, queries, and communication per AHIMA guidelines.
- Provides education and resources to RA coding team to ensure they are up to date with all relevant information as applicable to their role.
- Facilitates and directs provider and RA coding team education efforts for risk adjustment.
- Works with RA educator specialist to develop effective education content related to coding/billing, HCC, and risk adjustment concepts.
- Ensures education specialist is providing accurate and up to date education content to providers, coders, and CDI team in effective and appropriate venues.
- Serves as a resource for colleagues, physicians, and as liaison to internal departments and external customers.
- Collaborates with colleagues across the network and acts as HCC RA model, pro-fee coding, and clinical data core measure subject matter expert to disseminate outcomes and education.
Requirements
What you’ll need- Specialized Diploma CPC, CCS, or CRC with exceptional relevant background experience or Associate’s Degree RN or RHIT with exceptional relevant background experience or Bachelor’s Degree BSN or RHIA with exceptional relevant background experience or Master’s Degree advanced degree Registered Nurse, Nurse Practitioner or Physician Assistant.
- 5 years recent advanced clinical or risk adjustment coding experience and extensive knowledge of complex disease processes in an acute care hospital setting or 2 years Clinical Documentation Specialist (CDS) experience.
- Knowledge of ICD-10-CM/PCS, CPT/HCPCS, modifier assignment, principles of risk adjustment, and severity of illness scoring.
- Experience with acute care coding, clinical documentation improvement, utilization management, billing, auditing various healthcare payers and knowledge of DRG classification system strongly preferred.
- Ability to establish and maintain strong verbal and written communication with executive leadership and clinicians.
- Essential technical/motor skills: requires excellent observation skills, analytical thinking, problem solving, and excellent verbal and written communication.
- MS Office proficient and experience with electronic medical record systems.
- CRC - Certified Risk Adjustment Coder - State of Pennsylvania Upon Hire or CCDS-Cert Clinical Documentation Spec ACDIS - State of Pennsylvania Upon Hire or CDIP-Clin Documentation Improvement Prof CCHIIM - State of Pennsylvania Upon Hire
Benefits
Comp & perks- Health insurance
- 401(k) matching
- Flexible work hours
- Paid time off
- Professional development opportunities
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
risk adjustment codingclinical documentation improvementICD-10-CMICD-10-PCSCPTHCPCSmodifier assignmentseverity of illness scoringacute care codingbilling auditing
Soft Skills
analytical thinkingproblem solvingverbal communicationwritten communicationcoachingtrainingperformance monitoringcollaborationleadershipeducation
Certifications
CPCCCSCRCRNRHITBSNRHIACDSCCDSCDIP