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Health Information Administrator
3 months ago
Position:
Health Information Administrator (NACRS)
Department:
UHN Data and Analytics
Location:
Atrium on Bay
Status:
Temporary Part Time hours per week for 12 months
Salary N003:
$ $31.38 per hour (Commensurate with experience and consistent with UHN Compensation Policy)
UHN Digital delivers information management and technology services for the entire organization and is responsible for assisting UHN staff and students in transforming lives and communities.
JOB SUMMARY:
As an integral member of the Coding and Abstracting Department, the Health Information Management (HIM) Professional - NACRS Coder, utilizes his or her technical, analytical and decision-making skills to make appropriate interpretations of ambulatory clinical documentation, drawing upon his or her knowledge of medical and surgical terminology, anatomy, pathology, physiology, pharmacology, and the national and provincial coding standards
:
The HIM professional communicates with physicians, residents, nurses, nurse practitioners, nurse managers, business managers, performance measurement analysts, and data quality analysts to exchange information and serve as a resource for coding-related issues
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The HIM Professional - NACRS produces information that has strategic importance to the following initiatives:
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_ Calculation of hospital funding_
- Hospital Accountability Agreement signed by the Hospital Board with the Local Health Integration Network (LHIN)
- Strategic planning, clinical utilization management, and performance measurement/monitoring
- Patient Satisfaction Survey (Emergency and Ambulatory Oncology)
- Patient Safety and Quality of Care (e.g., AMI monitoring for Safer Healthcare Now)
DUTIES AND RESPONSIBILITIES
Ambulatory Coding
The HIM professional draws upon his or her knowledge of anatomy, pathology, physiology, medical and surgical terminology, pharmacology, and national and provincial coding standards and conventions to make appropriate interpretations of the patient experience as described in relevant dictated and/or written clinical documentation associated with an ambulatory (emergency and day surgery) visit for the purpose of coding and abstracting all mandatory health data required to complete a National Ambulatory Care Reporting System (NACRS) abstract as per the Canadian Institute for Health Information (CIHI) guidelines, Ontario Ministry of Health (MOHLTC) directives and University of Health Network (UHN) strategic initiatives.
Diagnosis
- Interprets and determines all relevant conditions described by the physician and/or other health providers associated with the ambulatory visit being reviewed.
- Evaluates conditions to determine impact on resource use and appropriately assigned significance using diagnosistyping conventions.
- Diagnose code selection using the International Statistical Classification of Diseases and Related Health Problems, 10th edition (ICD10CA) classification system. Utilization of an electronic codebook to search for appropriate codes taking into account all inclusion and exclusion criteria.
- Sequences codes appropriately in order to assign the case in the suitable Comprehensive Ambulatory Classification System (CACS) grouping. This determines the resource intensity weight (RIW) value of the case that reflects the estimated cost of managing the visit relative to the national standard or average.
- Weighted cases are reported in the Ontario Ministry of Health and Longterm Care (MOHLTC) Hospital Accountability Agreements and impacts hospital funding.
Intervention
- Interprets the operative report and/or other procedure notes to determine all relevant interventions performed on the patient during their hospital stay.
- Uses the Canadian Classification of Health Interventions (CCI) classification system to select appropriate intervention codes.
- Follows the CIHI Coding Standard for coding all interventions that affect Comprehensive Ambulatory Classification System (CACS) assignment. Appropriately abstracts and sequences procedures identified as flagged interventions, and any interventions specified as mandatory in other chapters within the Standards, taking into account all notes, inclusion and exclusion criteria.
- Identifies the principal procedure, which is defined as the most resource intensive intervention performed on the patient. Sequences intervention codes correctly to ensure its impact on CACS assignment and Ambulatory Case Weight (ACW) calculations. Correct CACS assignment and ACW calculation will translate into appropriate funding for the hospital.
- When applicable, codes and abstracts appropriate intervention attributes such as status (eg. primary or revision), location (eg. right, left, bilateral) and extent (eg. number of bypassed coronary arteries).
Providers
- Identifies all providers, which includes attending physician(s
