Episcopal Health Services Inc. (EHS) is a health system located on the Rockaway Peninsula in Queens, New York. EHS provides inpatient, outpatient, and emergency care to the diverse populations of the Rockaways, Five Towns, South Nassau, and beyond. The system offers comprehensive preventive, diagnostic, and rehabilitative services to people of all faiths.
St. John's Episcopal Hospital is accredited by The Joint Commission's Health Facilities Accreditation Program and is approved by the New York State Department of Health. The hospital is a recipient of the Gold-Plus Get with the Guidelines-Stroke Quality Achievement Award and the Gold-Plus Get with the Guidelines-Heart Failure Quality Achievement Award from the American Heart Association. Additionally, St. Johns is proud to be redesignated as a Baby-Friendly Hospital by Baby-Friendly USA - the accrediting body and national authority for the Baby-Friendly Hospital Initiative (BFHI) in the United States.
Come Grow With Us!
Type: Full-Time (75 hours biweekly)
Shift: Days
Hours: Varies
Salary: $86,000
POSITION SUMMARY:
Possesses strong clinical foundation with respect to differential diagnoses, disease interactions, pathophysiology, and treatment protocols
Demonstrates mastery of ICD-10-CM/PCS coding guidelines
Serves as liaison between providers and coders, with respect to crosswalk between clinical language and coding terminologies
Educates provides on clinical documentation best practices aligned with ICD-10-CM/PCS Official Guidelines for Coding and Reporting
Performs audits of medical records to ensure that provider documentation is accurate and complete and that correct ICD-10-CM/PCS codes are captured
Fosters collaborative relationships with Hospital Leadership, providers, clinical teams, quality teams, compliance teams, and coding team
Displays excellent oral and written communication skills
Demonstrates proficiency developing and delivering presentations for training and education
Demonstrates proficiency with DRG grouper software and electronic health records (e.g., Meditech, Epic)
ESSENTIAL FUNCTIONS:
Demonstrates qualities outlined in the "Customer Service Standards of Excellence" program when interacting with patients, their families and friends, and fellow employees
Maintains compliance with internal and external policies, procedures, regulations, industry guidelines and objectives, HIPAA and safety standards
Develops, coordinates and performs internal auditing activities, to ensure compliance with best practices for clinical documentation and coding
Collaborates with inpatient coders to support accurate APR-DRG and MS-DRG assignment
Writes clinical appeal letters and supports denial management process
Generates clinically robust queries for providers and adheres to AHIMA Guidelines for Achieving a Compliant Query Practice
Communicates with providers to obtain timely and compliant query responses
Tracks, analyzes and trends data to identify opportunities for performance improvement
Monitors, tracks and maintains key CDI metrics
Educates providers on documentation best practices to ensure the most appropriate and specific ICD-10-CM/PCS codes are captured in accordance with State, Federal and other accrediting agencies
Collaborates with interdisciplinary teams to identify opportunities and establish a unified approach for clinical documentation review, audit and education
Collaborates with Clinical Applications department to create and implement EMR components for complete and accurate provider clinical documentation and appropriate APR-DRG and MS-DRG assignment
Designs and presents CDI program metrics to Hospital Leadership
Leads and/or participates in meetings pertaining to CDI