OP CDI Supervisor-RN

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The Outpatient Clinical Documentation Specialist Supervisor (OPCDS Supervisor) is responsible for the daily operations of the outpatient clinical documentation program. The OPCDS Supervisor will actively work with organizational leadership to design, plan, implement, and evaluate solutions that support and enhance business practice, administrative and management needs. Facilitates and promotes standardization across client by alignment of high-quality documentation and coding that supports compliant and accurate medical record documentation. Oversee the programs organizational goals, performance improvement plans, and collaborate with coding, quality, population health, compliance, other healthcare professionals, and ambulatory clinics.  This position will act as a liaison for providers, medical group leadership, ambulatory clinics regarding appropriate clinical documentation, coding rules and regulations, HCC coding and Risk Adjustment analysis and reimbursement guidelines. The OPCDS Supervisor utilizes knowledge of official coding guidelines, quality metrics, Hierarchical Condition Categories (HCC), and AHIMA/ACDIS physician query brief to track and identify opportunities to validate accurate documentation, compliance, and resources to sustain the programs outcomes and success.
 

• Applies subject matter expertise regarding proper provider documentation driving accuracy of diagnosis codes for complexity and medical necessity, which improves quality of care and patient outcomes for outpatient services and associated risk adjustment. 
• Provide oversight and act as a resource for staff working in the system. Coordinate, compile, and share data reflecting the activity associated with the program.
• Provide ongoing feedback to physicians and other providers regarding coding guidelines and requirements. Assist with educational in-services for physicians, other providers, and clinic staff relating to clinical documentation compliance as well as new policies and procedures related to billing.
• Manage and provide oversight of day-to-day operations of the clinical documentation improvement practices to ensure consistency, meet corporate compliance guidelines, and to ensure appropriate and effective reimbursement.
• Manage employees to ensure productivity, quality and review standards are met and maintained. Reevaluate and adjust productivity and quality metrics as the department evolves due to internal and external changes. Formulating action plans based on results to improve the metrics of the department.
• Evaluate, implement, and adjust staffing plan to meet entity volumes, ensuring the needed coverage to meet the department’s key performance indicators. Identify, design, and implement efficient and effective workflows across the department.
• Evaluate operations and technology continuously and recommendations to collect and ensure the effectiveness and integrity of tracked data that is monitored and reported on case reviews/queries and document results achieved.   
• Demonstrates ability to build strong working relationships with providers, administrators, other healthcare professionals and revenue cycle colleagues.  Collaborate with the stakeholders, providers, and other leadership, to share feedback and guidance on documentation opportunities to develop actions plans to improve and sustain changes and improvements.
• Understand various payment structures, fee schedules, and reimbursement methodologies in the outpatient setting, and physician encounters, and how physician documentation translates into ICD-10-CM and HCC risk adjustment for claims submission to meet reporting requirements.  
• Prioritize and organize time and materials, balancing physician documentation and education needs with competing priorities and deadlines.  Create and analyze reports for documentation improvement trending and high-level dashboards for ongoing monitoring and opportunities.  
• Demonstrate responsibility and accountability for personal development by participating in continuing education internal/external offerings for HCC documentation requirements, ICD-10-CM code assignment and coding guidelines. 

Location: Remote,
Type: Contract
Pay: Apply for details

1518

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