Quality CDI Analyst, RN
Open to Texas residents ONLY. Texas Connect, Inc. (TCI) is a Management Services Organization (MSO). As an MSO, we are dedicated to providing business and administrative services for healthcare providers, such as medical practices and hospital systems, allowing them to focus on patient care. TCI handles crucial backend functions, such as Information Technology, Billing, and Medical Coding. This allows our client healthcare organizations to delegate these and other essential, but non-medical tasks to TCI to improve operational efficiency. Serves as a lead and data expert on the Hospital Inpatient Quality Reporting (IQR) Programs, as well as system coordinator for the Vizient Clinical Data Base (CDB) product. Will be responsible for medical record review, facilitating clinically appropriate documentation of all patient conditions, treatments, and interventions to accurately reflect the reason for admission, conditions present on admission, quality of care, severity of illness, and risk of mortality to support correct coding, reimbursement, and quality initiatives. Requires an understanding of the information needs of a health care setting and a knowledge of hospital workflow/operations and coding classifications in order to provide meaningful data for informed decision making. Other responsibilities include data analysis and compilation, metric education, process evaluation and auditing. SPECIFIC SKILLS NEEDED
- Ability to write queries that are concise and easily understood by the provider in order to obtain additional information and clarification of documentation
- Ability to interpret specifications for the IQR Programs
- Ability to reference and interpret CMS guidelines and regulatory requirements
- Strength in ICD10 and MSDRG structures, HACs, PSIs, value based purchasing, bundled payments, accountable care organizations and readmission reduction programs
- Extensive knowledge of pharmacology and pathophysiology and disease processes
- Strength in attention to detail—highly organized
- Ability to work independently with a high degree of selfmotivation
- Strength in data collection, formatting, and management
- Strength in the Microsoft suite of software
- Excellent communication skills, both verbal and written
- Persistent demonstration of accountability, accuracy, thoroughness, and sound judgment
- Ability to anticipate needs and place audience at the center of own thinking and actions
- Ability to establish and maintain effective working relationships with all departments
- Strength in risk identification and appropriate escalation
- Able to deal with frequent change or unexpected events
EDUCATION/EXPERIENCE/TRAINING Required:
- CCS or CCDS required by the end of employee probation period (typically 90 days), with onsite hospitalbased clinical experience
- Bachelor’s Degree in Nursing from a recognized college or university
- Must have and maintain an active RN license in your state of residence
- Two years direct patient care experience in an acute hospital
- Two years criteriabased chart review experience (i.e., Case Management, Utilization management, Managed Care, Quality Improvement)
- Evidence of continuing education and selfdevelopment
Preferred:
- Comprehension of various hospital business lines
- Experience working with coding classifications (i.e. ICD10 CM and PCS, CPT, and HCPCS)
- Experience in use of the AHA Coding Clinic
- Experience in data management, data analysis, Clinical Informatics, and/or statistical analysis
- Experience with the Vizient Clinical Database (CDB), or equivalent application
About TEXASCONNECT INC Texas Connect, Inc. (TCI) is a Management Services Organization (MSO). As an MSO, we are dedicated to providing business and administrative services for healthcare providers, such as medical practices and hospital systems, allowing them to focus on patient care. TCI handles crucial backend functions, such as Information Technology, Billing, and Medical Coding. This allows our client healthcare organizations to delegate these and other essential, but non-medical tasks to TCI to improve operational efficiency. https://www.texasconnectinc.com