Associate Clinical Documentation Improvement Specialist
About The Position
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. You will enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.
Requirements
- RN License (BSN Required) OR Medical Degree
- 3+ years of experience with acute care hospital clinical RN OR Medical Graduate with CDI
- Intermediate level of proficiency using a PC in a Windows environment, including Microsoft Word, Excel, Power Point and Electronic Medical Records
Nice To Haves
- 5+ years of acute inpatient hospital coding with certifications
- 3+ years of CDI experience for an acute care hospital
- Strong understanding of clinical medicine, pathophysiology, and pharmacology
- Strong grasp of ICD-10 coding, coding conventions, and guidelines
- CCDS, CDIP or CCS certification
- CAC experience (Computer Assistant Coding)
Responsibilities
- Perform concurrent and retrospective chart reviews for improving the overall completeness of clinical documentation
- Keep abreast of current coding trends and maintain up to date knowledge of Medicare rules and regulations regarding diagnosis coding and CDI current trends
- Effectively utilizes ICD-10 and related materials to investigate coding issues and produce accurate results
- Conducts daily follow-up communication with providers regarding existing clarifications to obtain needed documentation specificity
- Provides expert level leadership for overall improvement in clinical documentation by providing proficient level review and assessment, and effectively articulating recommendations for improvement, and the rational for the recommendations
- Actively communicates with providers at all levels, to clarify information and to communicate documentation requirements for appropriate diagnoses based on severity of illness and risk of mortality
- Provides complete follow-through on all requests for clarification or recommendations for improvement
- Ensures effective utilization of Optum® CDI 3D Technology to document all clarification activities
- Utilizes only the Optum360 approved clarification forms
- Proactively develops a reciprocal relationship with the HIM Coding Professionals
- Engages and consults with Physician Advisor /VPMA when needed, per the escalation process, to resolve provider issues regarding answering clarifications and participation in the clinical documentation improvement process
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
