Coding Auditor and Quality Coordinator

Summary

Join Northwestern Medicine as a Coding Quality Auditor and Specialist, playing a crucial role in ensuring the highest standards of clinical documentation and coding. Collaborate with the Clinical Documentation Team, physicians, and other providers to enhance documentation quality and maintain compliance with guidelines and regulations. This position involves advanced project work, including risk adjustment, mortality review, and quality abstraction. You will be responsible for developing and implementing educational strategies, analyzing data, and creating action plans to improve quality metrics. The ideal candidate possesses expertise in clinical documentation integrity and coding compliance, coupled with strong analytical and problem-solving skills. Northwestern Medicine offers competitive benefits, including tuition reimbursement, 401(k) matching, and lifecycle benefits.

Requirements

• RHIT or RHIA or CCS Certification
• Certified Clinical Documentation Specialist
• Bachelor Degree – Healthcare related
• Five years of coding experience in area of expertise
• Clinical expertise and understanding achieved through prior experience working with clinical documentation teams
• Strong personal computer skills (Word, Excel, PowerPoint, Visio)
• Excellent verbal, written, and presentation skills
• Demonstrates critical thinking skills
• Excellent interpersonal skills
• Planning and time management skills
• Educational/training experience

Responsibilities

• Collaborates with clinical documentation team in the review of inpatient accounts (with an emphasis on mortality reviews) identifying documentation improvement opportunities
• Assess DRG, PDx, secondary Dx, PCS, POA and all other components of documentation that impact quality metrics
• Consistently assures coding practices remain compliant with coding guidelines and regulations
• Continually identifies educational opportunities related to coding and documentation
• Expert educator to clinical teams and medical staff
• Identifies strategic plans that will result in a positive impact to the clinical dashboard
• Develops clinical relationships across the health system securing interdepartmental support necessary for successful implementation of education strategies assuring achievement of overall strategic targets
• Ability to multi-task a variety of audits
• Ability to analyze data and construct appropriate action plans
• Develops teaching tools to promote quality outcomes
• Is an active member of clinical and executive meetings as identified
• Advanced understanding of quality metrics for health system (Vizient, PSI, USNWR)
• Advanced understanding of clinical documentation and coding through the lens of local and national quality and ranking methodologies, including but not limited to, U.S News and World Report, Vizient, Leapfrog, the CMS Star Rating, and payer contracts and assists the Managers of Clinical Documentation and Coding in implementing key strategies to effect change
• Partners with Coding, Clinical Documentation leadership and Medical Directors to coordinate, maintain, and execute advanced project work that includes but, is not limited to, Mortality Review, HAC/PSI Review, Quality Abstraction and Analysis, and/or special and non-traditional project work
• Partners with NM departments that includes but is not limited to: IT; Analytics; and Innovation to design and implement new and advanced workflow solutions
• Partners with third-party consultants/partners to contribute to workflow and methodology build and refine as necessary

Preferred Qualifications

Master’s Degree in related field or currently enrolled in Master’s program

Benefits

• 401(k) matching
• Tuition reimbursement
• Loan forgiveness
• Lifecycle benefits