Health System Pharmacist Level I

NYC Health + Hospitals; New York (NY); On-site; USD 70,000 - 95,000; Full time

Job summary

NYC Health + Hospitals in New York City seeks a Health Information Management professional to supervise and perform medical record coding, documentation review, and DRG validation. Under supervision, you will ensure accuracy and compliance to coding guidelines across inpatient, outpatient, and ambulatory surgery records.

Responsibilities include conducting chart reviews, generating physician queries, monitoring denials and data quality, and training staff while collaborating with other

Qualifications

• Possession of a valid NY State license to practice pharmacy.

Responsibilities

• Validate completeness and accuracy of code assignments for inpatient, outpatient, and ambulatory surgery records.
• Monitor DRG assignment accuracy and data integrity.
• Generate physician queries to obtain clarification of documentation.
• Provide education and training to health information management staff.
• Collaborate with coding staff and management to ensure accurate reporting and reimbursement.

Skills

Pharmaceutical calculations

Basic knowledge concerning drug intera

Job description

Marketing Statement

Since 1875, South Brooklyn Health has established its reputation for clinical excellence and culturally competent care. It has designations as a Certified Percutaneous Coronary Intervention (PCI) Center, an Advanced Primary Stroke Center, an accredited Baby-Friendly Hospital, a U.S. News & World Report high performing hospital. The hospital's staff is as diverse as the patients they serve. Interpreter services can be provided at any time of the day or night in over 130 languages.

Marketing Statement

Since 1875, South Brooklyn Health has established its reputation for clinical excellence and culturally competent care. It has designations as a Certified Percutaneous Coronary Intervention (PCI) Center, an Advanced Primary Stroke Center, an accredited Baby-Friendly Hospital, a U.S. News & World Report high performing hospital. The hospital's staff is as diverse as the patients they serve. Interpreter services can be provided at any time of the day or night in over 130 languages.

At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.

Duties & Responsibilities

Purpose of Position

This class of positions encompasses supervisory and/or administrative work of varying degrees of difficulty and responsibility in the field of health information management. Performs quality review of records and/or documentation provided by clinical staff. Contributes to, and ensures the appropriateness of code and Diagnosis-Related Group (DRG) assignment in order to facilitate consistency, accuracy, and efficiency in claims processing, data collection, and quality reporting. All personnel perform related work.

Under supervision, performs assigned duties related to medical record and health information documentation, coding, validation, processing, and quality assurance.

Examples Of Typical Tasks

• Validates the completeness, accuracy, and specificity of code assignments for inpatient, outpatient, and ambulatory surgery records in accordance with established coding guidelines. Ensures that all documented diagnoses and procedures are properly coded.
• Validates the accuracy of DRG assignment.
• Validates the accuracy of additional information abstracted from the clinical record.
• Monitors denials and appeals. Performs DRG denial reviews for appropriate parties. Ensures that denials are responded to in a timely manner; submits monthly reports.
• Monitors data integrity and accuracy; makes necessary data corrections and entry. Performs chart review to determine data quality.
• Identifies and reports on cases with documentation inadequacies, inconsistencies, and other issues with opportunities for improvement. Evaluates root causes and proposes corrective action for same.
• Generates physician queries as needed in order to obtain clarification of medical record documentation. Validates that physicians have been queried according to established procedure.
• Confers with coding specialists, and oversees and evaluates work performance. Provides ongoing and specific feedback to coding staff and management team regarding review findings.
• Provides education and training to new and existing health information management staff.
• Instructs physicians, nurses, health information management staff, and other appropriate personnel regarding documentation requirements as related to coding.
• Works with other departments to ensure that accurate reporting and reimbursement are facilitated.
• Assigns codes for diagnoses and procedures according to the current classification system for inpatient, outpatient, and ambulatory surgery records and in accordance with established coding guidelines.
• Performs concurrent and retrospective clinical documentation review and provides data when necessary.
• Reviews and analyzes clinical records for compliance with appropriate regulatory requirements.
• Effectively utilizes computer applications and other coding and abstracting software and hardware as necessary.
• Performs other related duties as assigned or directed.

Minimum Qualifications

Possession of a valid NY State license to practice pharmacy.

Department Preferences

• Pharmaceutical calculations
• Basic knowledge concerning drug interactions