Supervisor Data Quality
WCO - Wellstar Corporate Office • Marietta, Georgia • Day Shift • Full Time • JR-0196Overview
The Supervisor Data Quality is a proactive member of an interdisciplinary team of licensed and unlicensed care givers who ensure that patients, families and significant others receive individualized high quality, safe patient care. It is expected that all RN Clinical Nurses – are licensed, knowledgeable and uphold the practice of nursing as outlined by the Georgia Professional Nurse Practice Act and implements the Scope of Practice and Code of Ethics Standards put forth by the American Nurses Association.
- Full Time
- Day Shift
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6+ years of experience
Success Profile
Find out what it takes to succeed as a Supervisor Data Quality:
- Collaborative
- Time Efficient
- Organized
- Critical Thinker
- Attention to Detail
- Compassionate
Benefits that Reflect Your Contributions
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Your Pay
A compensation program designed for fair and equitable pay.
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Your Future
Secure your future with plans that also include an employer match. Plans and guidance for the future.
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Your Wellness
Traditional healthcare benefits combined with progressive wellness programs to help you be your best self!.
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Your Joy
Special and unique benefits and programs ensuring a balanced life and a workplace culture built on trust.
Job Details
Facility: WCO - Wellstar Corporate Office
OverviewThe Data Quality Supervisor oversees the day-to-day coding audit/analyst workqueues, work assignments, personnel, and serves as a subject matter expert regarding but not limited to DRGs, APCS, ICD-10CM/PCS diagnoses and procedure codes for internal and external team members. In addition, the supervisor codes/audits accounts on a weekly basis. Provides trending feedback, applicable trending reports, and delivers education within department within areas of expertise.
The Data Quality Supervisor will use their knowledge and their teams to identify potential documentation, coding and reimbursement issues and report these to the Data Quality Manager and implement process improvements. The Data Quality Supervisor will gather this data in a presentable format to communicate to leadership, the coding/auditing staff as well as other leaders at WellStar, as directed. The Data Quality Supervisors will make quality improvement recommendations by identifying trends pulled from their insights as well as their team's insights and participate in implementing process improvements. The Data Quality Supervisor will provide/deliver executive style written and verbal reports to include analysis of metrics within owning area to leadership.
Responsibilities
Core Responsibilites and Essential Functions
* Monitor Auditing/Analyst work queues and auditing software to ensure compliance to Coding CFB, team goals and turnaround times are met. Assess/manages/assigns daily work/volumes. Directs and adjusts staff to volumes, PTO, vacancies, request for overtime, etc. to ensure team and CFB goals are met, seeking budgetary and managerial approval when needed.
* Direct daily operational needs throughout the day for Auditing/Analyst Team. Troubleshoot issues within the team as well as internal/external customers.
* Perform staff evaluations, coaching, and constructive feedback as needed. Deliver praise, positive feedback/reinforcement when applicable.
* Lead productive and timely team and 1-1 meetings with staff. Deliver quality/productivity metrics on team meetings and with individual staff. Ensure all staff meet required metrics and address both positive and negative results. Assist with recognition and process improvement plans.
* Manage staff time/hours/approvals within Kronos.
* Conduct thorough and prepared interviews and hire competent team members.
* Implement process improvements within scope of work as well as motivational and team building activities. Connect with staff positively and leverage individual’s strengths in an effort to use resources in the most effective manner.
* Conduct sporadic or specified coding audits to ensure quality team is meeting quality metrics
* Monitors daily staff productivity.
* Enforce accountability to WellStar Polices and Owning Area Policies and Procedures.
* PSIs, Vizient methodology, IMO Code requests, 2nd opinion requests from team, other requests from internal/external customers, etc.
* Investigating and responding to coding questions related to areas of expertise (i.e. inpatient, outpatient, and/or ED coding).
* Manage updates for the ‘Internal Departmental Coding Guidelines’. Communicate to internal/external customers upon approval from Manager.
* Review coding updates/trends from various sources and then communicates to Manager/Executive Director.
* Participate in identifying trends and issues for improvements from review of records, team feedback/meetings, and/or reports.
* Test software for owning area’s workflows, updates, new initiatives, etc.
* Maintains Coder Profile monthly.
* Monitors Auditing software for corrections at least weekly.
* Monitors Auditing software and/or reports for validity of Productivity Worksheets at least weekly. Maintains/Updates Productivity and Quality Auditing Spreadsheets and provides deliverable reports from metrics monthly.
* Creates and maintains updated instructions and tip sheets for all processes/software within scope of work for Auditors and Denial Analysts.
* Provides/maintains other reports to include but not limited to: Prebill and Mortality Auditing Results, Coder focused results, etc.
* Oversees management of onboarding of new coders to include but not limited to attending onboarding calls, communicating quality metrics to Data Quality and Coding Managers, and ensuring onboarding processes are followed.
* Onboard new Auditors/ Analysts to include contractors, if necessary.
* Interpret trending errors/reports to make recommendations based on results.
* Provide education within the department to include, but not limited to: trending errors, new code updates, etc.
* Refer to outside sources for additional education, as needed: 3M Nosology, Coding Clinic, CMS Website.
* Advocate for issues and improvement opportunities on behalf of owning area.
* Accurately and completely assigns appropriate ICD-10 CM/PCS and/or CPT/HCPCS codes to the greatest specificity with a minimum 95% accuracy rate.
* Accurately and completely abstracts all required data into the appropriate data fields in compliance with statistical data requirements with a minimum of 95% accuracy rate.
* Accurately assigns correct APC at a minimum 95% accuracy rate.
* Meet productivity standards.
* Queries physicians to further clarify code assignments, if needed.
Perform Coding Audits
* Validate that the codes, abstracted data and DRGs under focused review are assigned according to official coding guidelines and supported by clinical documentation in the medical record.
* Identify documentation improvement opportunities in DRG, APC, CPT, ICD-10 CM/PCS codes, POA, Point of Origin, Place of Transfer, and Discharge Disposition, and other coding and documentation elements, as needed.
* Provide feedback to coding staff on areas of opportunity.
* Validate adherence to WellStar Coding Policies and Procedures.
* Validate adherence to WellStar Coding Query Policy.
* Attend and provide notes back to the Manager for meetings: OCC, Denials, etc. Support other roles within the department.Participate as a Coding representative in meetings.
Required for All Jobs
Qualifications
Required Minimum Education
Required Minimum Experience
Required Minimum Skills
Required Minimum License(s) and Certification(s)
Additional Licenses and Certifications
Mission, Vision & Values
At a time when the healthcare industry is changing rapidly, Wellstar remains committed to exceeding patients’ and team members’ expectations, while transforming healthcare delivery.
Our Mission
To enhance the health and well-being of every person we serve.
Our Vision
Deliver worldclass health care to every person, every time.
Our Values
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We serve with compassion
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We pursue excellence
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We honor every voice
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