Specialist Coding Standards and Data Quality

Job Description

Summary

Reporting to the Regional Manager, Coding Informatics, Documentation and Data Quality, and working closely with the Coding Leadership Team and Coding team, the Specialist, Coding Standards & Data Quality provides LM HIM wide leadership and guidance to staff, HIM leaders and other individuals / groups in the Lower Mainland HIM, Coding.

Serves as an expert LM Health Information Management-wide resource to support the coding and data extraction from patients’ records for all the organizations.

The responsibilities of the role include ensuring Coding and relevant HIM staff is fully informed and in compliance with standards and procedures with respect to Coding of patient / client records and related processes and the role is accountable for developing, maintaining, delivering and evaluating Coding training for new and existing Coding team members.

Acts as a liaison with Coding Coordinators, HIM Managers, Ministry of Health and other internal / external stakeholders regarding standards and procedures and serves as the primary contact with CIHI with respect to the implementation of new or revised coding standards and updates;

incorporates best practices, leads data quality improvement initiatives; and assists with the definition and development of audit tools and evaluation methods.

Works with Manager to review and develop Coding and Coding Data Quality policies, procedures and standards and document for distribution.

Maintains related LM HIM manuals and systems with respect to coding standards, data quality and training. Provides input to Manager and Coding Coordinators on staff coding and data quality issues.

Assists with the modification of work processes to accommodate changes in standards or procedures. Provides orientation and training to staff in the related area.

Qualifications / Skills and Education

Education, Training, and Experience

Graduation from an accredited Health Information Management Diploma or Bachelor Program.

Five (5) years of recent, related experience in Coding inpatient and surgical day care records in a tertiary setting, including two (2) years as a data analytics or data quality analyst, or equivalent combination of education, training and experience.

Canadian College of Health Information Management (CHIM) certified and active membership with the Canadian Association of Health Information Management (CHIMA).

Travel between HIM sites requires access to a vehicle and a valid BC Driver’s License.

Skills and Abilities

• Demonstrated understanding of quality assurance techniques and processes related to continuous quality improvement.
• Demonstrated knowledge and ability to utilize report writer tools, such as Crystal Report design, MS SQL Server.
• Demonstrated ability to code in ICD-10-CA / CCI and abstract in the CIHI Discharge Abstract database.
• Demonstrated knowledge of Case Mix Groups, Comprehensive Ambulatory Classification System (CACS), Resource Intensity Weight (RIW) and Expected Length of Stay (ELOS).
• Demonstrated working knowledge and demonstrated ability to utilize computer software applications, including Microsoft office Word, Excel and Powerpoint.
• Demonstrated ability to lead, mentor and teach staff.
• Demonstrated ability to develop learning materials and tools.
• Ability to organize and prioritize workload.
• Ability to problem-solve.
• Ability to communicate effectively both verbally and in writing.
• Ability to work to deadlines under pressure, with minimal supervision and frequent interruptions.
• Ability to deal effectively with others, demonstrate leadership and maintain cooperative working relationships
• Knowledge of and ability to operate related computer programs and equipment.
• Physical ability to perform the duties of the position.

Duties and Responsibilities

1. Leads a variety of coding standards and data quality initiatives. Serves as an expert resource to Lower Mainland HIM Coders and other HIM personnel with respect to standards related to the coding of patient records and related processes.

2. Develops, maintains, delivers and evaluates Coding training materials for new hires, practicum and co-operative education students, and returning staff (from leaves).

3. Serves as the internal point of contact with respect to coding queries and liaises with CIHI, BCRCP, Surgical Patient Registry, BC Trauma Registry and other similar database programs, in order to have coding queries addressed, new or revised coding and data abstraction standards updated and implemented, and essential information disseminated to appropriate staff and stakeholders.

4. Acts as a liaison between Coding Coordinators, Coding Leadership, other HIM teams, Reporting / Analytic teams, Ministry of Health Services / Health Planning and the Canadian Institute for Health Information (CIHI) with respect to the quality of data obtained from the coding of patient records.

Specialist, Coding Standards and Data Quality (East, West) (001254) #3

May 1, 2003, March 29, 2010, March 2014, Revised May 2023

5. Works with the Coding Application Specialists to assist with programs and services exploring new modes of health care delivery where codified patient data is required to support program management (e.

g. SubAcute Care, Hospice Care). Works with Manager and Coding Coordinators to adjust work processes where necessary.

6. Serves as the primary contact with CIHI with respect to the implementation of new or revised coding standards and updates.

7. Develops policies and procedures and maintains manuals and systems with respect to coding standards and data quality.

Ensures distribution accordingly.

8. Develops and recommends the data quality audit process for Lower Mainland HIM Coding Services. The Specialist will employ appropriate quality assurance and quality improvement methodologies to move from issue identification to process improvement and ongoing evaluation.

9. Assists Manager and Coding Coordinators with the development of testing tools for hiring of coding staff and with defining acceptable proficiency levels.

Provides input to Manager and / or Coding Coordinators on identified staff deficiencies in data quality and coding and required training and development.

10. Liaises with other members of the LM HIM Leadership Team to ensure that coding standards and data quality efforts are consistent with the goals and objectives of LM Health Information Management.

11. May be required to travel periodically to HIM sites to provide in-person services.

12. Performs other related duties as required.

Vaccination Flag

As per the current Public Health Orders (Long Term Care / Seniors Assisted Living Provincial Health Order and the Health Sector Order), as of October 26, 2021, all employees working for Providence Health Care must be fully vaccinated against COVID-19.

Proof of vaccination status will be required.