Memorial Hermann Health System

Medical Billing and Coding

• Responsible for primary diagnosis and procedural coding for designated ambulatory and hospital outpatient setting
• Responsible for proficiently assigning proper and accurate medical codes for diagnosis, procedures, and services performed in an outpatient setting, such as, but not limited to emergency department, outpatient clinics, same day surgeries, or diagnostic testing (radiology and laboratory)
• Typically reports to the Coding Manager
• Reviews medical record documentation to identify pertinent diagnosis/procedures that require code assignment for outpatient records and accurately codes the diagnoses and procedures using ICD-10-CM coding conventions for the purpose of reimbursement, research, and compliance with federal regulations.
• Reviews the medical record to assure specificity of diagnoses, procedures, and appropriate reimbursement for hospital and professional charges.
• Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes.
• Keeps abreast of coding guidelines and reimbursement reporting guidelines and brings identified concerns to manager for resolution.
• Effectively assigns ICD-10-CM, modifiers, and HCPCS codes to outpatient records.
• Responsible in maintaining 95% or greater ICD-10-CM and/or HCPCS coding and consistently meet established productivity standards while keeping abstracting errors to a minimum.
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official coding guidelines.
• Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
• Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences.
• Models Memorial Hermann’s service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.

Certified Outpatient Hospital/Facility Coding Specialist

Auditor

• Ensures accuracy and completeness of clinical coding for reimbursement
• Conducts regular coding audits and ongoing monitoring of coding accuracy
• Develops educational sessions for coding staff
• Serves as a resource for coding standards and guidelines
• Designs audit tools to monitor coding accuracy
• Keeps abreast of coding guidelines and reimbursement reporting requirements
• Conducts trend analyses of coding practices
• Abides by ethical coding standards

Coding Compliance Auditor

• Ensuring the accuracy and completeness of clinical coding resulting in appropriate reimbursement and data integrity.
• Conducts regular coding audits and coordinates ongoing monitoring of coding accuracy.
• Develops and coordinates educational sessions to all coding staff regarding documentation and accurate coding.
• Serves as a resource for coding staff on organization-wide coding and documentation standards and guidelines.
• Designs audit tools to monitor the accuracy of clinical coding.
• Keeps abreast of coding guidelines and reimbursement reporting requirements.
• Conducts trend analyses to identify patterns and variations in coding practices.

Director

• Responsible and accountable for the Enterprise implementation of ACO Quality, Medicare Shared Savings Program (MSSP), and MHMD Network Performance.
• Organizing all aspects of data collection, report compilation/dissemination, and coordinated outreach efforts for ACO Quality, MSSP, and Network Performance efforts.
• Ensures that Practice Advisors are meeting service expectations to the independent practices.
• Designs and implements the ACO Quality operating model through the ACO Quality and RAF Operations Committee.
• Ensures compliance with MSSP program requirements.
• Responsible for leading a high-performance team of "system thinkers" who incorporate leadership principles and vision in performing the functions of their roles.

Director, Population Health Performance

Recruitment

• Collaborates with the physician and healthcare team in the delivery of patient care, utilizing the nursing process
• Delivers safe and appropriate care to patients, according to the nursing skills inventory and the age and needs of the patient/population served
• Coordinates the planning for the delivery of nursing care with an interdisciplinary team
• Participates in a systemic, interdisciplinary, and ongoing evaluation of programs, process improvement and desired client-centered outcomes
• Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards
• Promotes individual professional growth and development

Labor & Delivery RN, Central Staffing – Day Shift

• Collaborates with the physician and healthcare team in the delivery of patient care, utilizing the nursing process
• Provides professional nursing care to patients, including conducting nursing assessments, assisting with exams and treatment, patient education, and maintenance of medical records
• Delivers safe and appropriate care to patients, according to the nursing skills inventory and the age and needs of the patient/population served
• Coordinates the planning for the delivery of nursing care with an interdisciplinary team and administers appropriate clinical decisions in the delivery of patient care
• Participates in a systemic, interdisciplinary, and ongoing evaluation of programs, process improvement and desired client-centered outcomes
• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency

• Provides professional nursing care to patients
• Conducting nursing assessments
• Assisting with exams and treatment
• Patient education
• Maintenance of medical records
• Coordinates treatment plans and discharge/transfer plans
• Participates in evaluation of programs and process improvement

Adult Emergency Department RN – PRN Day Shift

• Collaborates with the physician and healthcare team in the delivery of patient care
• Provides professional nursing care to patients, including conducting nursing assessments, assisting with exams and treatment, patient education, and maintenance of medical records
• Coordinates the planning for the delivery of nursing care with an interdisciplinary team and administers appropriate clinical decisions in the delivery of patient care
• Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards

Strategy

• Manages the development and delivery of strategic and tactical information
• Interprets and advises Senior Leadership on strategic projects/studies
• Lead and execute strategic initiatives across clinical, operational, quality, and digital domains
• Analyze clinical, operational, financial, and digital performance data
• Partner cross-functionally with clinical, operational, quality, and digital/IT teams
• Evaluate, select, and work with external partners
• Support implementation of digital and operational solutions
• Translate strategy into execution, defining KPIs, tracking progress
• Identify and advance opportunities to improve care delivery

Manager, Corporate Strategy

Consultant

• Position is responsible for consulting, coaching and training department leaders and employees within specific care delivery sites on customer experience needs
• Collaborating with internal stakeholders on leveraging customer experience data to support enhancements to the customer experience
• Works as a consultant to build and maintain positive relationships with various department leaders to accomplish goals that improve customer experiences
• Creating and delivering new and/or existing presentations depending on site needs
• Conducts group training of staff depending on site needs
• Tracks and analyzes consumer experience data daily using Excel and other internal data sources
• Supports leaders through trainings, observations and action planning to ensure customer experience needs and customer metrics are met.

Ambulatory CEM Consultant

• Responsible for reviewing and abstracting inpatient medical records
• Identifying and assigning accurate medical codes for diagnosis, procedures and services
• Ensures that all data elements required for federal or state reporting and billing are collected
• Typically reports to the Coding Manager
• Reviews medical record documentation to identify pertinent diagnosis/procedures
• Queries physicians when code assignments are not straightforward or documentation in the record is inadequate
• Effectively assigns ICD-10 codes and DRGs to inpatient records
• Responsible in maintaining 92% to 95% in ICD-10 and DRG assignment
• Ensures safe care to patients, staff and visitors
• Promotes individual professional growth and development

Senior Certified Inpatient Coding Specialist

• Responsible for reviewing and abstracting inpatient medical records
• Identifying and assigning accurate medical codes for diagnosis, procedures, and services in an inpatient setting
• Ensuring all data elements required for federal or state reporting and billing are collected
• Reviews medical record documentation to identify pertinent diagnosis/procedures for inpatient records
• Queries physicians when code assignments are not straightforward or documentation is inadequate
• Keeps abreast of coding guidelines and reimbursement reporting guidelines
• Effectively assigns ICD-10 codes and DRGs to inpatient records
• Maintains 92% to 95% in ICD-10 and DRG assignment and consistently meets established productivity standards

Analyst

• The Lead Application Analyst is responsible for providing leadership and direction with the design, testing and implementing of complex information systems and solutions
• The Lead Application Analyst possesses advanced knowledge and skills in assigned software applications and various system environments
• The Lead Application Analyst is responsible for developing and following project schedules, plans and timelines
• The Lead Application Analyst also develops, conducts and evaluates training sessions for staff, as required
• The Lead Application Analyst participates in team projects, assists with group direction and guidance, coordinates work assignments and problem resolution efforts
• The Lead Application Analyst performs planning, conducting and evaluating of training sessions for end-users and Information Systems staff

Lead Applications Analyst

• Responsible for educating the organization on how to leverage their virtual health strategy in the best way to address consumer and clinical experience at scale
• Responsible for the co-creation, and subsequent execution of, Memorial Hermann’s Virtual Health Strategy to improve adoption of current capabilities
• Drives continuous evaluation and development of virtual product offerings to meet new consumer and operational needs; creating a center of excellence in virtual health
• Responsible for overseeing system remote patient monitoring solutions and their performance within overall virtual health strategy

Director – Virtual Health Digital Products

Data Scientist

• Leads the analysis of complex and unstructured data sets using advanced statistical methods for use in data driven decision making
• Responsible for leading cross-functional teams and providing in-depth data insights for complex business problems approached with advanced analytic techniques
• Manages engagement with internal customers on small and medium sized projects

Certified Outpatient Hospital/Facility Coding Specialist

Coding Compliance Auditor

Coding Compliance Auditor

Director, Population Health Performance

Labor & Delivery RN, Central Staffing – Day Shift

Labor & Delivery RN, Central Staffing – Day Shift

Adult Emergency Department RN – PRN Day Shift

Adult Emergency Department RN – PRN Day Shift

Manager, Corporate Strategy

Ambulatory CEM Consultant

Senior Certified Inpatient Coding Specialist

Senior Certified Inpatient Coding Specialist

Lead Applications Analyst

Director – Virtual Health Digital Products

Lead Data Scientist