As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA

This position is assigned to the Health Information Clinical Documentation Integrity (CDI) Department and acts as a catalyst for quality improvement initiatives related to clinical care documentation and coded data quality. This position will audit, identify, aggregate, report and educate to coded data and its impact on UUH clinical outcomes, patient safety, comparative data quality, outcomes measurement, and public reporting in close collaboration with: Inpatient Coding and CDI Staff, Inpatient Auditing and education, Quality and Patient Safety, CDI physician advisors/chief value officers (CVO), Hospital Providers, Other patient care staff, Health Information Department and hospital management.

Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.

• Review inpatient medical record documentation as it pertains to AHRQ, CMS, Vizient and other quality related metric to identify documentation gaps that may not accurately translate to ICD-10 classification.
• Seek clarification and resolution with physicians when gaps are identified.
• Audit ICD-10 coded data as it pertains to quality related outcomes measures to ensure accurate translation and outcomes reporting based on AHRQ, CMS, Vizient and other quality related metrics. Seek clarification and resolution with coding/CDI when gaps are identified.
• Manage and audit encounters via internal systems for identification of fallout cases in areas of high risk or opportunity for improvement.
• Perform 100% pre-bill review for all encounters related to mortality and/or Patient Safety Indicator (PSI), Hospital Acquired Condition (HAC), and/or Potentially Preventable Complication (PPC).
• Collaborate with Coding / CDI and Quality & Patient Safety to bridge the gap between the regulations and guidance applicable to both specialties.
• Analyze various mortality and risk models used to assess quality reporting measures. Identify new annual measures that will impact outcomes reporting, and identify gaps or trends that may need improvement.
• Assist with transformation of facts into actionable data to drive performance improvement initiatives, including preparation and presentation of educational material.
• Create and deliver reporting documents, summaries, and educational presentations related to quality audit activities.
• Develop and maintain effective collaborative working relationships with physicians, hospital leaders, and departments across the organization, and participate in multidisciplinary teams to support UHC mission, vision and values.
• Support timely, accurate and complete coded data used for measuring and reporting physician and hospital outcomes.
• Participate on assigned committees and/or performance improvement initiatives, as appropriate to responsibilities.

Knowledge / Skills / Abilities

• Demonstrated proficiency of state and federal regulations, as well as national quality standard oversight organizations (AHRQ, Vizient, CMS Core Measures, etc.) relative to the dissemination and use of clinical coding comparative data.

• Extensive knowledge of coding conventions & use of coding nomenclature, demonstrated proficiency of ICD-10 classifications, and thorough understanding of the effect coded data has on prospective payment, outcome models, utilization and reimbursement.

• Comprehensive knowledge of anatomy, physiology, pathophysiology, and complex medical procedures.

• Excellent analytical, critical thinking, and deductive reasoning skills.

• Ability to quickly and accurately review patient care documentation and audit ICD-10 coded data.

• Demonstrated excellent interpersonal, oral and written communication skills.

• Demonstrated ability to foster and maintain positive, collaborative, and effective business relationships with colleagues across the organization.

• Ability to identify and monitor trends and opportunities for documentation improvement.

• Proficient use of healthcare IT systems, including Epic and 3M 360 Encompass.

• Proficiency with Clinical Documentation Integrity (CDI) concepts, practices, and processes.

• Knowledge and ability to ensure and promote consistent, quality-oriented documentation best practices.

Qualifications

Required

• Bachelor's degree in a related field, or equivalency.
• Minimum five (5) years of experience coding inpatient facility (HB) at Level 1 Trauma facility.
• Extensive knowledge of clinical care operations, protocols, and best practice.
• Experience working in Academic Medical Center setting.

Licenses Required

• One of the following
  • Current CCS Certification with the American Health Information Management Association (AHIMA).
  • Current RHIA Certification with the American Health Information Management Association (AHIMA).
  • Current RHIT Certification with the American Health Information Management Association (AHIMA).

• One of the following
  • Current CDIP Certification with the American Health Information Management Association (AHIMA).
  • Current CCDS Certification with The Association of Clinical Documentation Improvement Specialists (ACDIS).

* Additional license requirements as determined by the hiring department.

Preferred

• Bachelor's degree in Nursing (BSN), MD, or related Master's degree.

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

• This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.