The position involves accurately assigning ICD-10-CM and CPT-4 codes to outpatient records for billing and reimbursement purposes. Additionally, the coder will perform data abstraction, review medical records for documentation deficiencies, and ensure compliance with regulatory standards.
The Utilization Management Specialist reviews inpatient and observation admissions to determine appropriate patient status and ensures continued criteria for level of care are met. They collaborate with physicians, case management, and insurance partners to facilitate authorizations and maintain accurate documentation.
The Nurse Clinical Informaticist will serve as a bridge between nursing practice and IT to optimize clinical workflows and EMR functionality. They are responsible for identifying system issues, developing solutions, and providing training to clinical staff to improve patient care quality.
