Continuous Quality Improvement Coordinator

Job Description Summary: The Continuous Quality Improvement Coordinator has knowledge of third-party billing procedures and documentation requirements across a variety of payer systems for both psychiatric outpatient and inpatient environments. They will also have knowledge of E&M coding review using 1995 E&M Guidelines, CPT, ICD-10CPM, and HCPCS coding. The primary responsibilities are supervising the Quality Assurance Specialists, monitoring QA audit reports, providing consultation and education to both clinical and support staff. The Continuous Quality Improvement Coordinator also supervises staff in the areas of Release of Information, Archived Records, Hospital Admissions Entry, Cimor Data Entry, Coding, and is a vital member of the Compliance Committee. They will also serve as Records Custodian for the Center. They will have a basic understanding of healthy interaction with individuals impacted by a variety of behavioral health (addiction/substance abuse and mental health) issues, recognizing that the individuals we serve often times have experienced trauma that affects their development and adjustment. They will be trained in trauma-informed care and will work to help create a work environment that is sensitive and responsive which will prevent victimization, abuse, or trauma. The Continuous Quality Improvement Coordinator reports to the Assistant Director of Quality Improvement.

Preferred Qualifications:

• High School diploma or equivalent is required with a minimum of one (1) years’ experience in clinical/medical office.
• RHIA, RHIT, CCS or CPC certification status is preferred.

Education:

• High school diploma or equivalent.

Responsibilities:

• Manage day-to-day operations of the Quality Assurance (QA) Department.
• Oversee monitoring, auditing, the correction of medical record documentation and coding completed by QA staff.
• Communicate results of QA documentation auditing to the Clinical Staff, Administrative Team, and Compliance Committee.
• Provide training and education to clinical, administrative, and support staff in the areas of documentation requirements, policies and procedures, compliance, release of information, coding, and data entry.
• Compile compliance audit reports for submission to the Compliance Committee.
• Apprise Director of Risk and Quality Improvement about trends in documentation or compliance issues identified by QA auditing.
• Coordinate and participate in internal and external audits.
• Perform all other duties as assigned.

The above statements are intended to describe the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to this job. Other duties may be assigned.

Physical Requirements:

• Normal Office environment.
• Typical physical demands include prolonged sitting, frequent standing, bending, stooping, and occasional lifting up to 10 pounds.
• Requires normal range of hearing and manual dexterity sufficient to operate keyboard, telephone, photocopier, calculator, and other office equipment as needed.
• Requires ability to work under stressful conditions and to work irregular hours.
• TB Test upon hire.