Job ID: EB-20606419544 Job Position: Clinical Reimbursement Manager Location: Manhattan, NY Category: Healthcare and Healthcare IT Salary: 70K Share this with someone you know: Overview: Our client, a prestigious Academic Acute Care Medical Center, located in the heart of Manhattan, is seeking a Clinical Reimbursement Manager for their growing HIM department. Will be responsible for performing quality reviews on medical records to validate the ICD-9-CM codes, DRG appropriateness, missed secondary diagnoses and procedures, and ensure compliance and accuracy of the MS-DRG and APR DRG. This position is based in Manhattan with an option to work remotely.

Responsibilities: * Performs data quality reviews on inpatient records to validate the ICD-9-CM codes, MS-DRG or AP-DRG, APR-DRG, identify missed secondary diagnoses and procedures, and ensures compliance with all DRG mandates and reporting requirements.* Continuously evaluates the quality of clinical documentation to identify incomplete or inconsistent documentation for inpatient encounters that impact the code selection and resulting DRG groups and payment. Communicates with attending physician either verbally or through written methodology to validate observations and suggest additional and/or more specific documentation as it relates to coding compliance, medical necessity and documentation improvement.* Provides feedback to HIM management staff and CDI leadership regarding opportunities for documentation improvement and participates with the planning and development of educational programs directed towards improving documentation.* Creates and monitors inpatient case mix reports and APR-DRG accuracy to identify patterns, trends, and variations in the facility's frequently assigned DRG reports or specific areas impacting US News and World Report ratings. Once identified, the Clinical Reimbursement Manager evaluates the causes of the change or problems, and takes appropriate steps in collaboration with coding staff, HIM management staff, CDI leadership and the hospital administrative staff.* Demonstrates advanced knowledge about HIS standards of coding and applies to ongoing evaluation of medical record documentation in all facility care settings. To include ICD-9-CM and HCPCS coding principles.* Maintains the confidentiality of information acquired pertaining to patient, physicians, associates, and visitors to the Hospital. Discusses patient and hospital information only among appropriate personnel in appropriately private places.* Assists in the review and distribution of coding related information to clinical staff, including CPT-4-CM and ICD-9-CM code changes, medical necessity policies and coding/billing information regarding new procedures and devices.* Assists in education and training of all coding team members Requirements: * Strong foundation in clinical medicine, ICD-9 CM and CPT-4 Coding.* Knowledge of medical terminology.* Excellent knowledge of federal and All-Payer DRG reimbursement methodology.* RHIT or RHIA with 3-5 years of related experience, working in acute care hospital setting.Smith Arnold Partners is a Stamford, Connecticut based highly specialized technical professional and executive search firm that has helped thousands of companies and people make a professional connection. Smith Arnold Partners has successfully completed searches on behalf of the most recognizable firms in the United States.