BI Analyst - IT
Location: Omaha, Nebraska
Description: Children's Hospital & Medical Center is presently looking of BI Analyst - IT right now, this position will be delegated in Nebraska. More complete informations about this position opportunity please read the description below. Works collaboratively with the Billing compliance Manager in conducting physician coding audits, related training, and resolving NCCI (National Correct Coding Initiative) billing e! dits. Determines appropriate CPT codes for all Hybrid Catheterization & Electrophysiology Lab procedures, serves as the HIM expert for Epic Enterprise and handles special projects, as assigned.
Essential Functions/Competencies
% of Time
30%
Perform coding audits for physicians and advanced practice clinicians (APC’s), such as nurse practitioners and physicians in collaboration with the Billing Compliance Manager
Ensure Documentation in ChartMaxx and Epic is reviewed to determine if it supports the codes billing
This includes CPT codes, HCPCS(Healthcare Common Procedure Coding System) codes and ICD-9/ICD-10 diagnosis codes.
Audit results are summarized and shared with each physician and APC providing appropriate education as necessary
In conjunction with the Billing Compliance Manager, trains newly hired physicians and APCs in documentation and code selection for Evaluation and Management services
!
Researches and responds in a timely, accurate and profess! ional manner to coding inquiries from physicians, APCs and other internal parties
Works collaboratively with coders throughout the organization, including those in the Central Billing Office, the Pediatric Orthopaedics department, the Pediatric Surgery department and HIM.
30%
Resolves NCCI (National Correct Coding Initiative) billing edits prior to claims being released to payers.
Ensuring familiarity with the CPT codes involved and the NCCI manual and database
Work closely with the billers in the Central Billing Office on these claims.
Contact representatives from patient care departments to discuss the charges hitting the edits, as needed.
Reference materials including CPT assistant, Coders’ Desk Reference, Coding Clinic, etc.
25%
Codes all procedures performed in the Hybrid Catheterization & Electrophysiology Lab
Identifies coding problems that require intervention and implementin! g methods for diagnosis and repair
15%
Serves as the HIM coding application specialist for the purposes of the Epic Enterprise build, implementation and post-go-live system enhancements. Maintain in-depth knowledge of current processes, workflows, work queues, and vision to maximize Epic Enterprise functionality.
Regular attendance at work is an essential function of the job.
Perform physical requirements as described in the Physical Requirements section
SECONDARY FUNCTIONS/COMPETENCIES
5%
Performs other duties as assigned
100%
JOB STANDARDS
Achieves department/organization Outcomes
All
Patient/Customer Satisfaction
Interacts with patients/families/customers and utilizes feedback to improve and reinforce satisfaction
Meets department/organization satisfaction goals
Financial
Identifies and implements systems and processes to improve! efficiency and reduce expenses that do not compromise quality of servi! ces/mission.
Meets department/organization financial goals
Quality
Utilizes performance measurement to improve patient/customer outcomes
Meets department/organization quality goals
Dept.
Specific
Patient/Customer Satisfaction
Provides same-day response for 90% of all customer inquiries
For customer inquiries requiring research, provides an initial response to 100% of all inquiries within24 hours
Financial
For audits of CPT/HCPCS/diagnosis codes which includes locating documentation in ChartMaxx and/or Epic; scoring the history, exam and medical decision making and documenting findings, the typical time required per account is:
Clinic Accounts: 15 Minutes
Inpatient and observation accounts: 30 minutes
Quality
Performs all essential functions at 95% accuracy rate
Takes personal responsibility to adhere to department/orga! nization policies and procedures, compliance and regulatory agency requirements
All
Understands and performs role in emergency situations (i.e. disruptive individuals, internal/ external disaster, CPR, Code Adam)
Understands and practices regulatory agency standards and department/organization policies/procedures including: Joint Commission, OSHA, HIPAA, Infection Control, Environment of Care, National Patient Safety Goals
Addresses non-compliance with department/organization standards
Meets mandatory department/organization job requirements within established time frames (i.e. physicals, annual mandatory reviews, participates and physically attends 75% of required staff meetings, licensure/certification, CPR for direct care providers)
Dept.
Specific
Documents findings, rationale, supportive materials, etc, as appropriate for future reference
Maintains copies of appropriate records in electroni! c or paper format.
Supports a work environment that focuses on! staff, customer, patient/families through safe practices and effective communication.
All
Demonstrates and supports staff/visitor/patient/vendor identification policy
Utilizes variance reporting system to enhance safety and identify changes for best practice
Protects Patient Privacy
Incorporates department/organization communication into work practices
Dept.
Specific
Stays informed by reading e-mail in a timely manner
Demonstrates professional, courteous and respectful communication with all customers
Treats co-workers with respect and dignity to ensure a positive work environment
BEHAVIORS
Excellence in Service to Children, Families, Colleagues and Other Customers
Anticipates customer needs, understands their expectations and responds appropriately.
Respect for Human Dignity
Treats others with compassion, fairness, courtesy and respect whi! le honoring their uniqueness.
Cooperative Work Relationships
Willingly works with others to identify and achieve common goals.
Positive Attitudes and Behaviors
Enthusiastically approaches their role and displays pride in the organization
Honesty and Integrity
Takes personal responsibility for doing the right thing.
Wise Use of Resources
Optimizes the talents of self and others and the use of time, materials and equipment.
KNOWLEDGE, SKILLS AND ABILITIES:
Knowledge of medical terminology, anatomy, and physiology
Knowledge of CPT, HCPCS, and ICD-9/ICD-10 coding
Familiarity with coding-related reference materials, such as CPT Assistant, Coders’ Desk Reference, Coding Clinic, etc.
General knowledge of the billing process as it relates to NCCI edit resolutions.
Specialized knowledge related to the physiology and anatomy of the cardiovascular system.
In-depth knowledge of current HIM processes, workflows, and wor! k queues and the vision to maximize Epic Enterprise’s functionality
Detailed oriented
Appropriate levels of confidence and composure useful in sharing audit results with physicians and APC’s
Ability to work independently to effectively and efficiently perform assigned tasks
Ability to type 40 works per minute with 99% accuracy (with spell check)
EDUCATION AND EXPERIENCE:
High School Diploma or G.E.D. required
Minimum 5 years’ experience coding in a hospital, physician office, or insurance environment required, with experience in coding cardiac catheterization procedures and electrophysiology studies preferred
CERTIFICATIONS/LICENSURE REQUIREMENTS:
CPC (Certified Professional Coder), CCS (Certified Coding Specialist) or CCS-P (Certified Coding Specialist- Physician-based) certification required
Epic Certification (e.g., Epic Certified Trainer, Application Builder with expertis! e in the HIM Coding Applications ???
SPECIAL REQUIREMENTS:
REQUIRED TRAINING & EMPLOYEE HEALTH REQUIREMENTS
Annual Physical
Annual Mandatory Review
PHYSICAL REQUIREMENTS/WORKING CONDITIONS:
Physical Requirements
N/A
Less than 10%
11% to 49%
Greater than 50%
Work Environment
N/A
Less than 10%
11% to 49%
Greater than 50%
Stand
X
Blood and body fluid exposure*
X
Walk
X
Sharps, needles, etc.
X
Sit
X
Wet, humid conditions (non-weather)
X
Talk or hear
X
Work near moving mechanical parts
X
Displays manual dexterity
X
Fumes or airborne particles
X
Climb or balance
X
Toxic or caustic chemicals
X
Stoop, kneel, crouch or crawl !
X
Outdoor weather conditions
X
Reac! h with hands and arms
X
Extreme cold (non-weather)
X
Taste or smell
X
Extreme hot (non-weather)
X
Lifting/pulling/pushing
X
Risk of electrical shock
X
Visual: Looking at computer screen
X
Medical Equipment
X
Other:
Risk of radiation
X
Weight Demands:
Vibration
X
Up to 10 lbs.
X
Loud noise
X
Up to 20 lbs.
X
Quiet environment
X
Up to 40 lbs.
X
Environmental noise
X
Up to 100 lbs.
X
Other:
More than 100 pounds
X
- Refer to the Infection Control Manual for a listing of job classifications which may be at risk of occupational exposure.
- .
If you were eligible to this position, please give ! us your resume, with salary requirements and a resume to Children's Hospital & Medical Center.
Interested on this position, just click on the Apply button, you will be redirected to the official website
This position will be started on: Sat, 15 Jun 2013 00:56:42 GMT