Job Description

Supervisor, Clinical Document Integrity (CDI)

Full Time, 80 Hours Per Pay Period, Day Shift

Covenant Medical Group Overview:

Covenant Medical Group is the employed and managed medical practice organization of Covenant Health, providing comprehensive care across East Tennessee. With more than 300 physicians and advanced practice providers in 20 communities, our team delivers expertise across a broad spectrum of specialties from primary care and walk-in clinics to preventive medicine and advanced surgical and subspecialty services. We are committed to offering coordinated, patient-centered care that spans the continuum of health needs, ensuring access to exceptional providers close to home.

Under the direction of the Covenant CDI Manager, oversees all activities of daily operations and supervision of employees of the CDI department at Covenant Medical Group. Monitors the following on a daily basis to ensure goals are met and to prevent delays that affect financial performance: all unbilled accounts receivable claims for all coding deficiencies including those claims that have failed edits and are in need of correction.

Instills an equal appreciation in Coding personnel for complete and accurate information and the financial and clinical ramifications of all work processes. Maintains optimal communication links with Integrity Office, Quality Management, and CBO. Customer service mentality is crucial, as is a good working relationship with affiliated departments and employees.

Responsibilities include interviewing, hiring and training new employees; and developing a consistently reliable service that adheres to quality, budget, and timeliness. Establishes and monitors individual employee’s quality and quantity standards assuring these standards are consistently met. Ensures adherence to enterprise-wide policies, procedures, guidelines, and training manuals. Enforces standards for quality and timeliness based on customers' needs and in accordance with HIPAA, CMS and other related State and Federal guidelines.

Responsible for the coding accuracy and timeliness of the coding to meet regulatory and organizational requirements. The coding services are crucial to the cash flow of Covenant and have a direct impact on Covenant’s financial performance.

Responsibilities

• Under the direction of the CDI Manager, directs the day-to-day activities in the centralized medical coding operation to service the various business entities of Covenant Health, which includes the planning and maintenance of daily activities and special projects as necessary to achieve and maintain business objectives. Business entities include companies directly under the Covenant Health umbrella.
• Responsible for team building and bringing together the coding staff from existing and new Covenant facilities into a central organizational structure and work group.
• Ensures compliance to departmental policies and procedures, objectives, quality assurance programs and safety standards.
• Assists with planning, directing and supervising of all coding activities.
• Monitors the various reports to assure staff work to meet goals set relative to Days in Accounts Receivable, Unbilled Accounts and accounts with coding errors.
• Assists with planning for annual operating and capital budgeting.
• Monitors for changes in coding laws and regulations, and assures that staff is informed and educated in a timely manner.
• Assists with the implementation of the continuing education programs for the coding staff.
• Works closely with Integrity compliance and CBO personnel to assure that close linkages is maintained with special reference to coding, documentation, billing and collection issues. Works on identified issues relative to denials of payment, as it relates to coding.
• Assists with planning education efforts for CMG practices.
• Works with Physician coding educators within the CDI department to develop educational content and opportunities.
• Provides education, daily processes, and training opportunities for HCC coders.
• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.
• Performs other duties as assigned.

Qualifications

Minimum Education:

None specified; however, must be sufficient to meet the standards for achievement of the below indicated license and/or certification as required by the issuing authority.

Minimum Experience:

Three (3) years of medical record experience in a supervisory role, acute care experience preferred. Familiarity with the Joint Commission, state and financial regulatory approach mandatory, as well as hospital finance, needed. Three (3) years coding experience required.

Licensure Requirement:

CPC or RHIT, and ICD10 training required.