Clinical Document Integrity Specialist 2, Managed Care Network Development Med Mgmt, FT, 8:30A-5P
About The Position
Responsible for improving the overall quality and completeness of clinical documentation. Facilitates modifications to clinical documentation through extensive interaction with physicians, nursing staff, other patient caregivers, and medical records coding staff to ensure that appropriate reimbursement is received for the level of service rendered to all patients with a DRG based payor. Ensures the accuracy and completeness of clinical information used for measuring and reporting physician and medical center outcomes. Educates all members of the patient care team on an ongoing basis. Active participation in team meetings and education of staff in the CDMP process is a key role.
Requirements
- Doctor of Medicine / DO.
- International graduates of medical school, or RN with MBA preferred.
- Four years of recent clinical experience adult, pediatrics, obstetrics hospital inpatient medical, surgical and critical care setting.
- Four years of recent clinical documentation improvement experience in adult/pediatric hospital in-patient medical/surgical and critical care setting.
- Basic computer skills (familiarity with windows based software programs).
Nice To Haves
- CDIS certification preferred.
- Experience in Milliman and Interqual preferred.
- Leadership experience, knowledge of legal aspects of coding, Medicare MS-DRG, Medicaid APR-DRG assignments, utilization management, case management, discharge planning, and or managed care experience preferred.
- Experience using healthcare web based applications, Milliman, Interqual, etc. preferred.
Responsibilities
- Improving the overall quality and completeness of clinical documentation.
- Facilitating modifications to clinical documentation through extensive interaction with physicians, nursing staff, other patient caregivers, and medical records coding staff to ensure that appropriate reimbursement is received for the level of service rendered to all patients with a DRG based payor.
- Ensuring the accuracy and completeness of clinical information used for measuring and reporting physician and medical center outcomes.
- Educating all members of the patient care team on an ongoing basis.
- Active participation in team meetings and education of staff in the CDMP process.
Benefits
- Career growth and development opportunities, with clear pathways and ongoing support
- Comprehensive health and wellness resources that go beyond traditional benefits
- A wellness program that can help employees eliminate their medical plan deductible, reducing out-of-pocket healthcare costs
- Tuition reimbursement to support continued learning and advancement
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Ph.D. or professional degree
