• Clinical Data Analysis Manger

    Requisition ID
    2018-13406
    Shift
    Day
    Category
    Finance
    Shift Hours AM/PM
    8:00AM-4:30PM
    Department
    SJ MED RECS
    Position Type
    Regular Full-Time
  • Overview

     

    St. Joseph’s Healthcare System is recognized for the expertise and compassion of its highly skilled and responsive staff. The combined efforts of the organization’s outstanding physicians, superb nurses, and dedicated clinical and professional staff have made us one of the most highly respected healthcare organizations in the state, the largest employer in Passaic County, and one of the nation’s “100 Best Places to Work in Health Care”.

     

     

     Job Overview

     

    Responsible for managing the operation of the medical record coding/abstracting staff to ensure the timely and accurate coding of all pertinent diagnoses and procedures, that the DRG assignments are based on accurate and properly sequenced diagnoses and procedures, and ensures that abstracted data elements from the medical records are entered into Quantim data base timely, accurately and statistically meaningful.

    Responsibilities

    Actively monitors Discharge Not Final Billed (DNFB), Outpatient Exception Report (OER) reports, work closely with Patient Financial Services to ensure accurate and timely billing. Reviews coders work for accuracy, productivity, quality, DRG assignments and verify compliance with ICD-9-CM, CPT and HCPCS guidelines utilizing essential compliance tools. Troubleshoots and resolves billing problems, admitting problems, non-compliant physician documentation and performs all management functions which include support educational in-services. Assists in the implementation of Policy/Procedure changes within the department related to coding and quality issues required by 3rd party payors and recommendations of coding consultants and/or agencies. Reviews and prepares response to DRG/coding audits (i.e.. BC, CBIZ, RAC and other payors). Meets all required competencies for department, unit and/or hospital. Responsible for performing all other duties as assigned. Special Projects

    Qualifications

    Work requires the knowledge of theories, principles and concepts normally acquired through completion of a Bachelor’s Degree in Health Information Management, Nursing or a closely related field and three to five years of previous work related experience,. Registration required as a Registered Nurse or Registered Record Administrator. Work requires analytical ability to collect information from diverse sources and apply professional principles in performing various analyses, and summarize the information and data in order to solve problems.

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