Application Case Management Principles For Health Information Management

 

Objectives Develop a job posting for a HIM coding position Collaborate with the HR department to decide the recruitment methods most appropriate for recruiting for this position Develop specific job-related questions to be asked during the interview process

Instructions

This application case relates to recruiting a new employee for an open position. The deliverables (recruitment methods, job posting,  interview questions, recruitment plan) apply to any open position regardless of department or discipline.  As a manager, director, or administrator you may have oversight for positions that are not in your own discipline and do require researching skills to determine the best plan.

 

Scenario

A large healthcare organization is expanding HIM centralized coding services based on the recent acquisitions of a rural hospital, long-term acute-care hospital, skilled nursing facility, and a behavioral health facility. All the coding functions for these newly acquired facilities will be centralized within the HIM department. Based on a work volume study it is estimated the HIM department will need four additional full-time equivalent (FTE) clinical coding specialists to perform the additional coding from the acquisition of these new facilities. Laura, the HIM coding manager, is responsible for working with the HR department consultant to develop a recruiting plan for these four open positions. Laura will need to provide a written recruitment plan to the HIM director of the organization.

Assumptions The job description for the clinical coding specialist has recently been updated by Laura and is provided following this case study in figure 7.2. Interviews for both internal and external candidates will be performed as structured interviews. Follow the standard HR department recruitment process: All jobs are posted internally for two weeks and qualified candidates will be referred to the coding manager for interviewing. If qualified individuals are not hired internally, the job posting will then be advertised externally using the recruitment methods identified in the recruitment plan. A different advertisement may be necessary for the internal and external job postings.

 

Review the scenario provided and the Clinical Coding Job Description in figure 7.2 to develop a job posting and appropriate interview questions. Provide a written report to the HIM director that contains all the deliverables outlined.

 

Figure 7.2. Clinical coding specialist sample position description

Clinical Coding Specialist Sample Position Description

Initial Date: 01/01/2016

Review Date:  Department: Health Information Management

Job Title: Clinical Coding Specialist         
Reporting Relationship: Reports to HIM Coding Manager, Health Information Management; no direct reports

Pay Grade: Non-Exempt, Grade IV

Job Purpose: The purpose of this position is to apply the appropriate diagnostic and procedural codes to individual patient health information for data retrieval, analysis, and claims processing.

Job Responsibilities and Tasks

Clinical Classification Coding Assigns ICD-10-CM/PCS, HCPCS, and CPT codes accurately utilizing the 3M encoder. Assigns Present-on-Admission (POA) indicators appropriately. Groups all coded data to MS-DRGs, APR-DRGs, and APCS utilizing the 3M encoder. Keeps abreast of coding guidelines and reimbursement reporting requirements. Distinguishes appropriate coding as outlined by facility’s coding guidelines. Abides by the Standards of Ethical Coding as set forth by AHIMA and adheres to official coding guidelines. Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes by utilizing the appropriate facility querying process. Analyzes health record documents to ensure that the information is timely, complete, and accurate according to facility standards.

Abstracting Performs abstracting from the EHR as appropriate. Ensures that data adheres to data standards as outlined within the HIM policies and procedures.

Electronic Health Record Utilizes the health record documentation contained in the EHRs as the source of truth for coding. Utilizes dual screens for coding and reviewing EHR documentation efficiently. Identifies issues with copy and paste in patients’ EHRs and reports them to the HIM coding manager.

Job Requirements and Specifications Proficient in the utilization of the following classification systems: ICD-10-CM/PCS, CPT, and HCPCS. Ability to maneuver within EHR systems. Proficient in the use of encoders within the coding process, 3M encoder preferred.

HIT Job Competencies

Subdomain I.A. Classification Systems Apply diagnosis or procedure codes according to current guidelines. Level of Learning: Applying Evaluate the accuracy of diagnostic and procedural coding. Level of Learning: Evaluating Apply diagnostic and procedural groupings. Level of Learning: Applying Evaluate the accuracy of diagnostic or procedural groupings. Level of learning: Evaluating

Subdomain 1.B. Health Record Content and Documentation

Analyze the document in the health to ensure it supports the diagnosis and reflects the patient’s progress, clinical findings, and discharge status. Level of Learning: Analyzing.

Verify the documentation in the health record is timely, complete, and accurate. Level of Learning: Analyzing.

Subdomain 1.C. Data Governance

Apply policies and procedures to ensure the accuracy of health data. Level of Learning: Applying

Subdomain 1.D. Data Management

Collect and maintain health data. Level of Learning: Understand.

Job Qualifications Associate degree in health information technology with RHIT credential or bachelor’s degree in HIM with an RHIA credential. Additional AHIMA coding credential preferred: CCS, CCS-P. At least one year previous coding experience within a healthcare organization is required.

Job Context Ability to work in an office environment and perform repetitive computer tasks related to coding. Potential to work from home after six months of required in-hospital training.

Deliverables

Develop a clinical coding specialist recruitment plan in collaboration with the HR consultant. The plan needs to include the following items. Three recruitment methods outlined in this chapter with an explanation as to why each of these methods was chosen. A job posting based on the clinical coding specialist job description in figure 7.2 that advertises for these positions. If necessary, a different one may be done for the internal and external job postings. Two interview questions for each of the four categories of questions: situational, behavioral, job knowledge, and work requirement for a total of eight questions. The questions must be specifically focused toward clinical coding specialist job tasks. Create a clinical coding specialist recruitment plan report (in a memo) that includes the previous items.

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