Quorum Health

• Assumes responsibility and accountability for admission and concurrent reviews • Analyzes patient records to determine legitimacy of admission, treatment, and length of stay in health-care facility • Compares inpatient medical records to established criteria • Abstracts data from records and maintains statistics • Determines patient review dates according to established diagnostic criteria • Coordinates first, second and third level appeals • Manages appeals to ensure timely submissions • Forms professional relationships with payer appeals and utilization departments • Prepares and presents information on appeals to applicable committees

• The Clinical Documentation Integrity Specialist (CDIS) Lead is an advanced level position for the experienced and proficient CDI Specialist consistently meeting or exceeding all criteria for CDIS advanced performance. • The CDIS Lead provides support to CDI leadership within a defined scope of facilities and CDI team. • The CDIS Lead serves as a liaison between senior leadership, medical staff, nursing, coding, case management and quality departments. • Key Responsibilities: May be assigned special projects related to CDI processes, quality, data analysis, or HIM/CDI performance. • Assumes responsibility for daily workflow process and adjustments for the CDI team. • May present CDI performance metrics at facility meetings. • May present CDI education as needed. • Will assume operational oversight in the absence of the CDI Director. • Supports CDI team through multidisciplinary approach in support of program goals. • Facilitates collaborative efforts between CDI, HIM and Medical Staff providers. • Facilitates collaborative efforts between CDI and clinical teams such as Quality and Case Management. • Effectively utilizes leadership abilities and critical thinking skills to identify opportunities for team process and engagement optimization. • Maintains professional competency in documentation and coding practices by keeping up to date with new coding guidelines, policies/procedures, federal and state reimbursement.

• Responsible for assigning appropriate diagnostic and procedural codes to patient charts of moderate to high complexity using ICD-10-CM, ICD-10-PCS, CPT, HCPCS or any other designated coding classification system in accordance with coding rules and regulations. • Abides by the Standards of Ethical Coding as set forth by AHIMA. • The Outpatient Coder shall review hospital outpatient medical documentation or physician medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM, CPT and HCPCS codes with outpatient encounters to ensure proper coding, billing and compliance. • Will match outpatient coding area to experience (i.e. Same Day Surgery, Routine Outpatient, Physician, Recurring, Observation, etc.). • Reviews encounter to assign and sequence appropriate diagnoses and/or procedure codes as well as modifiers to diagnostic, physician and/or surgical encounters in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP), guidance in encoder software and HIM coding policies and procedures. • Using 3M encoder, reviews Ambulatory Payment Classifications (APC) and coding edits. • Reviews Local/National Coverage Determination (LCD/NCD) edits and guidance for codes meeting medical necessity. • Research electronic medical record for any additional diagnoses documented to meet medical necessity.

• Responsible for performing full cycle recruiting functions including but not limited to job understanding, candidate sourcing, social networking, phone screening, email communication, documentation, summary writing and presentation. • Identifying candidates with the right skills to match the requirements. • Regularly interacting with Hiring Manager to understand the openings, shifts, and all requirements. • Make use of effective resourcing strategies, such as cold calling, ATS and job board sourcing, schools, networking, and employee referrals. • Must have experience on full Life Cycle of Recruiting (screening resumes, interviewing, offer extension). • Maintaining the candidate database.

• Lead CDI strategy, planning, development, implementation and maintenance of CDI program. • Manage projects associated with Mid Revenue Cycle and CDI initiatives. • Maintain processes aligned with regulatory and legal requirements. • Direct and manage the Clinical Documentation Integrity team. • Collaborate with Coding and HIM leadership to maximize outcomes. • Promote physician and provider education, engagement and collaboration.

Outpatient Acute Care Coder You must reside in one of these states to be eligible for this position: Arkansas    California    Kentucky Massachusetts Nevada    New Mexico Oregon     Utah     Tennessee Texas     Wyoming Employment Type: Full Time Location: Remote Reports To: Coding Operations Manager Job Summary: Responsible for assigning appropriate diagnostic and procedural codes to patient charts of moderate to high complexity using ICD-10-CM, ICD-10-PCS, CPT, HCPCS or any other designated coding classification system in accordance with coding rules and regulations. Abides by the Standards of Ethical Coding as set forth by AHIMA. - The Outpatient Coder shall review hospital outpatient medical documentation or physician medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM, CPT and HCPCS codes with outpatient encounters to ensure proper coding, billing and compliance. - Will match outpatient coding area to experience (i.e. Same Day Surgery, Routine Outpatient, Physician, Recurring, Observation, etc.) - Reviews encounter to assign and sequence appropriate diagnoses and/or procedure codes as well as modifiers to diagnostic, physician and/or surgical encounters in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP), guidance in encoder software and HIM coding policies and procedures - Using 3M encoder, reviews Ambulatory Payment Classifications (APC) and coding edits. Reviews Local/National Coverage Determination (LCD/NCD) edits and guidance for codes meeting medical necessity. Research electronic medical record for any additional diagnoses documented to meet medical necessity. - Ability to assign Physician E/M levels and charges for all relevant procedures performed in various settings, if applicable. - Ability to assign injections and infusions, if applicable. Qualifications: - One to three years’ experience performing medical record coding in acute care setting required. - High school diploma or equivalent is required. - Associate of bachelor’s degree in Health Information, Nursing, or other related field, or formal coding classes completed and passed preferred. Years of coding experience will be considered in lieu of educational requirements. - Functional Knowledge of EMR (Electronic Medical Record), Encoder and CDI Tools and other Support Software. - Comprehensive understanding of UHDDS guidelines, CCI Edits, Coding Clinic, etc. - Microsoft Office (Word, One Note, Excel, Outlook, PowerPoint) proficient. - Excellent verbal and written communication skills. - Ability to meet assigned deadlines. Work Experience, Education, and Certifications: - Associate degree preferred. - 1 year of Acute/Physician Coding Experience. - AHIMA or AAPC Certification required such as RHIA, RHIT, CCS, CPC, CIRCC, COC Software/Hardware: - 3M360 experienced required. Benefits: - Competitive salary and benefits package. - Opportunities for professional development and advancement. - Supportive work environment with a collaborative team. - Comprehensive healthcare coverage. - Retirement savings plan. - Paid time off and flexible scheduling options. - Student loan repayment program.

Outpatient Acute Care Coder You must reside in one of these states to be eligible for this position: Arkansas    California    Kentucky Massachusetts Nevada    New Mexico Oregon     Utah     Tennessee Texas     Wyoming Employment Type: Full Time Location: Remote Reports To: Coding Operations Manager Job Summary: Responsible for assigning appropriate diagnostic and procedural codes to patient charts of moderate to high complexity using ICD-10-CM, ICD-10-PCS, CPT, HCPCS or any other designated coding classification system in accordance with coding rules and regulations. Abides by the Standards of Ethical Coding as set forth by AHIMA. - The Outpatient Coder shall review hospital outpatient medical documentation or physician medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM, CPT and HCPCS codes with outpatient encounters to ensure proper coding, billing and compliance. - Will match outpatient coding area to experience (i.e. Same Day Surgery, Routine Outpatient, Physician, Recurring, Observation, etc.) - Reviews encounter to assign and sequence appropriate diagnoses and/or procedure codes as well as modifiers to diagnostic, physician and/or surgical encounters in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP), guidance in encoder software and HIM coding policies and procedures - Using 3M encoder, reviews Ambulatory Payment Classifications (APC) and coding edits. Reviews Local/National Coverage Determination (LCD/NCD) edits and guidance for codes meeting medical necessity. Research electronic medical record for any additional diagnoses documented to meet medical necessity. - Ability to assign Physician E/M levels and charges for all relevant procedures performed in various settings, if applicable. - Ability to assign injections and infusions, if applicable. Qualifications: - One to three years’ experience performing medical record coding in acute care setting required. - High school diploma or equivalent is required. - Associate of bachelor’s degree in Health Information, Nursing, or other related field, or formal coding classes completed and passed preferred. Years of coding experience will be considered in lieu of educational requirements. - Functional Knowledge of EMR (Electronic Medical Record), Encoder and CDI Tools and other Support Software. - Comprehensive understanding of UHDDS guidelines, CCI Edits, Coding Clinic, etc. - Microsoft Office (Word, One Note, Excel, Outlook, PowerPoint) proficient. - Excellent verbal and written communication skills. - Ability to meet assigned deadlines. Work Experience, Education, and Certifications: - Associate degree preferred. - 1 year of Acute/Physician Coding Experience. - AHIMA or AAPC Certification required such as RHIA, RHIT, CCS, CPC, CIRCC, COC Software/Hardware: - 3M360 experienced required. Benefits: - Competitive salary and benefits package. - Opportunities for professional development and advancement. - Supportive work environment with a collaborative team. - Comprehensive healthcare coverage. - Retirement savings plan. - Paid time off and flexible scheduling options. - Student loan repayment program.

Outpatient Acute Care Coder You must reside in one of these states to be eligible for this position: Arkansas    California    Kentucky Massachusetts Nevada    New Mexico Oregon     Utah     Tennessee Texas     Wyoming Employment Type: Full Time Location: Remote Reports To: Coding Operations Manager Job Summary: Responsible for assigning appropriate diagnostic and procedural codes to patient charts of moderate to high complexity using ICD-10-CM, ICD-10-PCS, CPT, HCPCS or any other designated coding classification system in accordance with coding rules and regulations. Abides by the Standards of Ethical Coding as set forth by AHIMA. - The Outpatient Coder shall review hospital outpatient medical documentation or physician medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM, CPT and HCPCS codes with outpatient encounters to ensure proper coding, billing and compliance. - Will match outpatient coding area to experience (i.e. Same Day Surgery, Routine Outpatient, Physician, Recurring, Observation, etc.) - Reviews encounter to assign and sequence appropriate diagnoses and/or procedure codes as well as modifiers to diagnostic, physician and/or surgical encounters in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP), guidance in encoder software and HIM coding policies and procedures - Using 3M encoder, reviews Ambulatory Payment Classifications (APC) and coding edits. Reviews Local/National Coverage Determination (LCD/NCD) edits and guidance for codes meeting medical necessity. Research electronic medical record for any additional diagnoses documented to meet medical necessity. - Ability to assign Physician E/M levels and charges for all relevant procedures performed in various settings, if applicable. - Ability to assign injections and infusions, if applicable. Qualifications: - One to three years’ experience performing medical record coding in acute care setting required. - High school diploma or equivalent is required. - Associate of bachelor’s degree in Health Information, Nursing, or other related field, or formal coding classes completed and passed preferred. Years of coding experience will be considered in lieu of educational requirements. - Functional Knowledge of EMR (Electronic Medical Record), Encoder and CDI Tools and other Support Software. - Comprehensive understanding of UHDDS guidelines, CCI Edits, Coding Clinic, etc. - Microsoft Office (Word, One Note, Excel, Outlook, PowerPoint) proficient. - Excellent verbal and written communication skills. - Ability to meet assigned deadlines. Work Experience, Education, and Certifications: - Associate degree preferred. - 1 year of Acute/Physician Coding Experience. - AHIMA or AAPC Certification required such as RHIA, RHIT, CCS, CPC, CIRCC, COC Software/Hardware: - 3M360 experienced required. Benefits: - Competitive salary and benefits package. - Opportunities for professional development and advancement. - Supportive work environment with a collaborative team. - Comprehensive healthcare coverage. - Retirement savings plan. - Paid time off and flexible scheduling options. - Student loan repayment program.

• Provides clinically based, concurrent and retrospective reviews of all inpatient medical records. • Ensures documentation accurately reflects quality of care, severity of illness and risk of morality to support correct coding, reimbursement and quality initiatives. • Proactively contacts physicians or other clinicians as needed to clarify procedures/diagnoses to ensure proper documentation. • Performs initial case reviews and follow up reviews. • Submits queries to providers as needed to ensure complete documentation of relevant diagnoses. • Assigns diagnosis codes following the Official Guidelines for Coding and Reporting and AHA Coding Clinics to obtain an accurate working DRG. • Promotes a partnership with Coding/HIM team to ensure the accuracy of principal diagnosis, procedures, and completeness of documentation to determine the working and final DRG, severity of illness and risk of mortality.

Outpatient Acute Care Coder Responsible for assigning appropriate diagnostic and procedural codes to patient charts of moderate to high complexity using ICD-10-CM, ICD-10-PCS, CPT, HCPCS or any other designated coding classification system in accordance with coding rules and regulations. Abides by the Standards of Ethical Coding as set forth by AHIMA. Employment Type: Full Time Location: Remote Reports To: Coding Operations Manager Job Summary: - The Outpatient Coder shall review hospital outpatient medical documentation or physician medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM, CPT and HCPCS codes with outpatient encounters to ensure proper coding, billing and compliance. - Will match outpatient coding area to experience (i.e. Same Day Surgery, Routine Outpatient, Physician, Recurring, Observation, etc.) - Reviews encounter to assign and sequence appropriate diagnoses and/or procedure codes as well as modifiers to diagnostic, physician and/or surgical encounters in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP), guidance in encoder software and HIM coding policies and procedures - Using 3M encoder, reviews Ambulatory Payment Classifications (APC) and coding edits. Reviews Local/National Coverage Determination (LCD/NCD) edits and guidance for codes meeting medical necessity. Research electronic medical record for any additional diagnoses documented to meet medical necessity. - Ability to assign Physician E/M levels and charges for all relevant procedures performed in various settings, if applicable. - Ability to assign injections and infusions, if applicable. Qualifications: - One to three years’ experience performing medical record coding in acute care setting required. - High school diploma or equivalent is required. - Associate of bachelor’s degree in Health Information, Nursing, or other related field, or formal coding classes completed and passed preferred. Years of coding experience will be considered in lieu of educational requirements. - Functional Knowledge of EMR (Electronic Medical Record), Encoder and CDI Tools and other Support Software. - Comprehensive understanding of UHDDS guidelines, CCI Edits, Coding Clinic, etc. - Microsoft Office (Word, One Note, Excel, Outlook, PowerPoint) proficient. - Excellent verbal and written communication skills. - Ability to meet assigned deadlines. Work Experience, Education, and Certifications: - Associate degree preferred. - 1 year of Acute/Physician Coding Experience. - AHIMA or AAPC Certification required such as RHIA, RHIT, CCS, CPC, CIRCC, COC Software/Hardware: - 3M360 experienced required. Benefits: - Competitive salary and benefits package. - Opportunities for professional development and advancement. - Supportive work environment with a collaborative team. - Comprehensive healthcare coverage. - Retirement savings plan. - Paid time off and flexible scheduling options. - Student loan repayment program.