Coding Integrity Specialist Jobs in Delaware (NOW HIRING)

Why ThedaCare?

Living A Life Inspired!

Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in health, enriching the lives of all and creating value in everything we do. Each of us are called to take action in delivering higher standards of care, lower costs and a healthier future for our patients, our families, our communities and our world.

At ThedaCare, our team members are empowered to be the catalyst of change through our values of compassion, excellence, leadership, innovation, and agility. A career means much more than excellent compensation and benefits. Our team members are supported by continued opportunities for learning and development, accessible and transparent leadership, and a commitment to work/life balance. If you're interested in joining a health care system that is changing the face of care and well-being in our community, we encourage you to explore a future with ThedaCare.

Benefits, with a whole-person approach to wellness -

• Lifestyle Engagement
  • e.g. health coaches, relaxation rooms, health focused apps (Wonder, Ripple), mental health support

• Access & Affordability
  • e.g. minimal or zero copays, team member cost sharing premiums, daycare

About ThedaCare!

SCHEDULE:
Hours of operation: The Heritage operates 24/7 365 however this position is only working during normal business hours
Workdays: Mon- Friday The position is for 40 hours per week we are hoping to find a candidate that will work 8-4
Work Hours: 8-4 there is some flexibility with the hours
Call: NO call
Weekend Call: NO weekend Call
Weekend/Holiday Rotation: No holiday rotation

Job Responsibilities:

• Develops and maintains staff schedules ensuring compliance with staffing ratios, and organizational policies. Manages team member call ins, no-shows, and shift adjustments
• Aligns with leadership on staffing census and acuity levels
• Monitors scheduling hours, overtime, and staffing-to-Resident ratios to support budget and compliance
• Administrative responsibilities such as compliance tasks, digitize appointment scheduling, coordinates resident follow up appointments, orders and referrals
• Coordinates transportation logistics for resident appointments, including scheduling, documentation and communication with Providers. Manages logistic schedules for residents and monthly SMV schedule
• Submits claims for nursing home-provided non-emergency medical transportation (NEMT) using HCPCS codes via the 1500 Health Insurance Claim Form of 837 Health Care Claim: Professional transaction to Forward Health
• Prepares and identifies invoices for private pay patients or their legal representatives for transportation services
• Ensures Center for Medicare and Medicaid Services (CMS) compliance for discharge planning and documentation
• Proactively schedules residents' health care appointments such as specialty visits, dental, and wellness to ensure residents' care needs are met to mitigate compliance concerns/risks
• Confirms team member credentials, licensing and certifications on regular basis for accurate compliance. Support team member training initiatives for completion
• Oversees inventory and supply ordering across multiple post-acute departments within an electronic spend-down system maintaining budget. Coordinates with vendors to prevent stockouts and reduce waste
• Responds to department and resident inquiries regarding product information in the ThedaCare item master.
• Responsible for new item builds using templates and maintaining data integrity.
• Facilitates daily morning meetings and coordinates action items within Froedtert ThedaCare departments. Communicates and align across departments for reporting purposes and follow up as necessary
• Meets new residents and/or interdisciplinary team within 72 hours of admission to screen and/or collaborate to gain understanding of clinical and social discharge needs, begin the discharge planning process, document findings in the medical record, and enable the CMS-required interdisciplinary care planning process to begin he discharge planning process, document findings in the medical record, and enable the CMS-required interdisciplinary care planning process to begin
• Monitor satisfaction surveys for Residents and family members. Partners with leadership providing recommendation and best practice for improving Resident satisfaction survey results. Ensure resident concerns are addressed with leadership for accurate follow up

Qualifications:

• High School diploma or GED preferred
• Must be 18 years of age
• Three to Five years of experience in a skilled nursing facility or acute care setting
• Completion of a state approved Social Work Designee course within six months of hire

Work Environment:

• Normally works in climate-controlled office environment
• Routine sitting with movement throughout office space
• Possible exposure to communicable diseases and hazardous materials
• Use of computers throughout the work day
• Flexible remote working aligning with business needs

Qualities:

• Ability to support, advance and live our mission and evidence of such: Mission - Our reason for Being - To advance the health of our communities through excellence and discovery, inspiring each person to live their unique best life