Medical Director

Accuity; New Jersey; On-site; USD 315,000 - 378,000; Full time

Job summary

A leading healthcare organization in New Jersey is seeking a knowledgeable Medical Director to oversee clinical documentation and coding practices. The role involves ensuring accuracy in patient care data and working closely with medical coding specialists. Candidates should have extensive medical training, clinical experience, and a commitment to quality patient care. This full-time position will require leadership skills and the ability to work effectively in a dynamic environment.

Qualifications

• Minimum of 5 years clinical experience including residency.
• Ability to work independently in remote or on-site settings.
• Strong knowledge of medical guidelines and coding standards.

Responsibilities

• Provide clinical leadership in an inter-disciplinary team.
• Validate clinical indicators for coded diagnoses.
• Generate compliant queries based on clinical indicators.

Skills

Leadership

Service

Compassion

Humanism

Diversity

Teamwork

Basic Microsoft Office Skills

Education

Graduate from an accredited medical school

Completion of an ACGME accredited US residency program

Tools

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Job description

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Description

The Medical Director, working together with a coder (DRG Integrity Specialist), will review inpatient charts to ensure the acuity and complexity of the patient’s hospital stay is appropriately captured in the clinical documentation and translated into coding. The Medical Director is responsible for capturing the true clinical picture in a manner compliant with federal laws and the healthcare organization’s information privacy practices through identification of coding and physician query opportunities. The Medical Director is responsible for overseeing every chart assigned to their team.

Description

The Medical Director, working together with a coder (DRG Integrity Specialist), will review inpatient charts to ensure the acuity and complexity of the patient’s hospital stay is appropriately captured in the clinical documentation and translated into coding. The Medical Director is responsible for capturing the true clinical picture in a manner compliant with federal laws and the healthcare organization’s information privacy practices through identification of coding and physician query opportunities. The Medical Director is responsible for overseeing every chart assigned to their team.

The Medical Director works with the DRG Integrity Specialist to confirm the principal diagnosis and the appropriate Diagnosis Related Group (DRG) of every case in compliance with coding guidelines. This process also involves the Medical Director confirming procedures, dates, and complication or comorbidity (CC) or major complication or comorbidity (MCC) when used as a secondary diagnosis.

The Medical Director validates clinical indicators for coded diagnoses, capturing the patient’s condition and ensuring the accuracy of the severity of illness and risk of mortality for the patient to illustrate the true clinical picture of the episode of care.

PRIMARY JOB RESPONSIBILITIES:

• Provide clinical leadership in an inter-disciplinary team in a professional, knowledgeable, and efficient manner to drive client results, exceed client expectations, and foster client confidence
• Maintain a functional and collaborative relationship with the DRG Integrity Specialist to achieve shared company goals
• Comply with medical and federal guidelines at all times
• Resolve conflicts quickly and professionally
• Stays up to date with medical guidelines, advancements within his or her field, and client-specific criteria
• Responsible for the quality of their teams work by developing and implementing strategic goals related to quality improvement within the tower
• Responsible for generating compliant queries based on appropriate clinical indicators for each diagnosis. Every query must meet all regulatory and reporting requirements
• Work with their manager to review tower analytics, identifying trends and actionable steps to improve opportunity capture rate and drive results for clients
• Work with Senior Management and Compliance Officer to adhere to organizational goals and mission
• Participate in corporate educational activities
• Utilize all technology, tools and resources to enhance performance and will be proficient in navigation of various electronic medical records
• Excel in a fast-paced, rapidly changing environment
• Exceed expectations in performance with regard to productivity and quality of his/her tower work, professionalism, and professional growth
• Take on additional responsibilities and demonstrate leadership at a departmental level
  
  

Requirements

POSITION QUALIFICATIONS:

Education:

• Graduate from an accredited medical school
• Preferred completion of an ACGME accredited US residency program
  
  

Experience:

• Minimum of a total of 5 years of clinical experience including residency
  
  

Knowledge, Skills, and Abilities:

• Academic Excellence
• Leadership
• Service, compassion, and humanism
• Diversity
• Ability to work as part of a team
• Basic Microsoft Office skills
• Ability to use a PC in a Windows environment, including MS Word, Excel and PowerPoint
• Independent, focused individual able to work remotely or on-site

Seniority level

• Seniority level

  Director

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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