Spec ICD 10 Implementation
HealthNow New York Inc. - Buffalo, NY

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Position Summary: The incumbent in this position serves as the primary business subject matter expert responsible for the successful implementation of ICD-10 projects. The specialist ensures a successful transition from current coding processes to ICD-10 by documenting business requirements, and by developing uses cases (as required), training materials, user test scripts, and acceptance criteria. The incumbent also serves as a liaison to the internal business and IT staff for ICD-10 subject matter expertise and external HEALTHeLINK, HEALTHeNET and HIXNY contacts, providers and vendors.

Primary Job Duties:
  • Serves as the ICD-10 Subject Matter Expert on projects/problems of diverse complexity and scope
  • Facilitates recommendations for actions/solutions to increase business efficiency and/or improve existing processes impacted by ICD-10
  • Partners with end users to gain understanding of HealthNow processes and environment and to refine business requirements
  • Ensures a successful transition from current coding processes to ICD-10 by documenting business requirements, and by developing uses cases (as required), and training materials
  • Collaborates with IT and business partners regarding business and/or technical solution implementations, upgrades, enhancements and conversions
  • Coordinates the development of test cases, test scripts and business User Acceptance Testing (UAT) with the business Subject Matter Experts
  • Ensures that users are adequately trained on new processes and coding schemas by developing communications and training materials
  • Provides coding oversight and serves as a reference for ICD-10 coding projects, and keeps current with knowledge of industry trends related to ICD-10.
  • Collects, tracks and analyzes ICD-10 trending data
Required Skills Primary Skills/Knowledge:
  • Experience with healthcare business processes. in-depth working knowledge of healthcare diagnosis and procedure coding (ICD-9) and knowledge of the ICD-10 code set
  • Experience with commercial data quality tools (e.g., DRG Grouper) to configure ICD codes, analyze, improve and control data quality
  • Familiarity with business process modeling
  • Extensive working knowledge of healthcare reimbursement concepts, particularly CMS and NYS DRG Grouping Methodology
  • Basic knowledge in CMS Medicare Advantage regulations as well as NYS DOH Medicaid
  • Ability to apply critical thinking and/or problem solving skills in order to identify an appropriate course of action and to reach a viable conclusion
  • Ability to manage multiple assignments simultaneously while maintaining quality standards and meeting assigned deadlines
  • Project coordination skills including business process modeling, strong follow-up, meeting facilitation and risk assessment/mitigation
  • Ability to maintain composure when addressing conflicting technical and business issues
  • Effective oral and written communication skills necessary to meet team collaboration, programming documentation and presentation standards
  • Ability to work in a fast-paced, collaborative environment with limited supervision
  • Ability to communicate clearly and concisely with all levels of the organization (technical and non-technical) and with outside contractors and vendors
Required Experience Preferred Education:
  • Associate's Degree in Health Information Coding or in a healthcare-related field required
  • Bachelor's Degree in Health Information Management or a related field of study preferred
Preferred Experience:
  • A minimum of two (2) years of work experience in acute inpatient coding or in a health plan required
  • (5) years of coding experience preferred
Working Conditions:
  • Must be able to occasionally attend off-site meetings, events, conferences
  • Must be able to work in an office environment
  • Must be able to accommodate regional travel. (DMV check will be conducted to review candidate's driving record)
  • Manual Dexterity Req: Eye-hand coordination and manual dexterity sufficient to effectively use a computer with all its components for prolonged periods of time and for the majority of required tasks
  • Manual Dexterity Req: Eye-hand coordination and manual dexterity sufficient to effectively utilize various office equipment (phone, computer, fax machine, printer, copier, filing cabinet, etc)
  • Physical Effort: Minimum; typical of most office work, mostly sedentary work.
  • Prolonged Sitting
  • Vision Req: Close vision (clear vision at 20 inches or less)
Required Licenses/Certifications:
  • Certified Coding Specialist (CCS) or Registered Health Info Tech/Admin (RHIT or RHIA)

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HealthNow New York Inc. is one of New York’s leading health care companies that provide access to quality health care and innovative...