Location: Remote
Position Summary
This position manages HIM’s Clinical Data Section, which is accountable for: coding and abstracting the medical records of inpatients, ambulatory surgery, urgent care, observation and outpatient clinics; preparing statistical analysis of medical records data; compiling, analyzing and summarizing data from medical records into various formats. The output of this Section is used for: meeting hospital licensure requirements; financial and billing purposes, which includes the identification and determination of appropriate reimbursement under inpatient and outpatient prospective payment systems; maintenance of acceptable accounts/receivables and DNB levels; compliance with internal and external regulatory agencies, such as Quality Improvement Organizations, the Centers for Medicare & Medicaid Services, and JCAHO. The position also coordinates hospital DRG activities through chart reviews, DRG validation activities, and provides information and reports to fulfill requests made by members of the medial staff, administration and planning.
Required Minimum Knowledge, Skills, and Abilities (KSAs)
Full working knowledge of: medical information and revenue cycle systems; Grouper and Severity of Illness Systems; medical record systems, medical terminology, anatomy, physiology, pathophysiology, microbiology, and pharmacology; State, Federal and JCAHO requirements pertaining to medical records; DRG prospective payment system.
Have current coding certifications for ICD-10. Skilled in ICD coding and case mix index management. Experienced with EPIC, HP CDM, claim edit processes, 3M encoder and CDI programs. Prior CAC and Lawson a plus.
A minimum of four years prior successful supervisory experience. Advanced education which should include communication and mathematical/statistical skills and/or extensive knowledge in organization, research and analysis normally acquired through the completion of Health Record Administration/Science Bachelor’s program with certification as an RHIA and coding credentials (CCS, CPC). Credentials are a job requirement and RHIT may be substituted for RHIA credentials provided held in conjunction with CCS and CPC certifications. Coding credential required within 6 months of hire date
Demonstrated abilities to: correctly interpret and apply Federal regulations and PRO requirements in the assignment of DRG’s, APCs and in the interpretation of various billing guidelines (i.e., medical necessity, resident supervision policies, correct coding initiative, etc. Ability to direct concurrent and retrospective coding reviews and provide physician education for the roll-out of ICD-10 CM and PCS.
Effective skills in leadership, communications, coaching, planning, motivation, and establishing effective working relationships with at all levels of staffing in the organization.
Additional Information Maine Medical Center is a Magnet designated 606-bed tertiary care and teaching institution. MMC is Maine’s largest hospital and a state-wide health care resource. MMC offers outstanding career opportunities and quality of life in Portland.
We offer benefits that support an individual’s needs for today and flexibility to plan for tomorrow. Our package includes health and dental insurances, paid parental leave, retirement program, generous paid time off, and much more! Our comprehensive array of benefits are competitive, affordable, and include choices that meet specific, but ever changing, needs.
MaineHealth is a not-for-profit integrated health system consisting of eight local hospital systems, a comprehensive behavioral healthcare network, diagnostic services, home health agencies, and over 19,000 employees. It is the largest health system in northern New England and provides preventive care, diagnosis and treatment to 1.1 million residents in Maine and New Hampshire.
With a career at any of the MaineHealth locations, you’ll be working with healthcare professionals that truly value the people around them – both within the walls of the organization and the neighborhoods that surround it. We are deeply invested in the wellbeing of our communities and employees. We believe in fostering a work environment of strong commitment, compassionate caring and continuous improvement. Our care – and the science behind that care – is top rate. Join us and your abilities will be challenged and enhanced as you take your career to another level.
Maine Medical Partners
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