Clinical Documentation Improvement Coordinator (CDI) - Full Time, Days (Culver City)

Prospect Medical • Culver City, CA

3h • Onsite

About The Position

The Clinical Appeals Coordinator works in collaboration with the team of
clinicians, coding professionals, physicians and HIM members to increase the
team’s program awareness, process and program benefits with the goal of
decreasing denials, enhancing performance and increasing reimbursement for the
health system. This person is a liaison for all government and commercial payer
appeals. Coordinates the appeals process, job aides and workflows, participates
in data gathering and analysis of reports regarding appeal activity as well as
prepares for appeals audits, monitors QI (Quality Improvement) activities of
appeals department, and assists in the development of department flows and
implementations. Maintains all documentation associated with the processing and
handling of appeals to comply with regulatory standards and timeframes.

Southern California Hospital at Culver City has been taking care of generations
of Culver City and west LA residents. We are a full-service, acute care hospital
with a 24/7 emergency department and nationally recognized patient safety. Now
at 420 beds, SCH-CC is a general acute care hospital that utilizes many of the
l latest medical treatments and technologies. The hospital offers a wide range of
inpatient and outpatient acute care services, including an orthopedic center,
cardiovascular services, acute rehabilitation, sub-acute care, psychiatric care
and chemical dependency programs. Additionally, SCH-CC operates a 24-hour
emergency services center, which serves as a paramedic receiving station and is
staffed by board-certified emergency physicians and nurse specialists.

Responsibilities

• Increase the team’s program awareness, process and program benefits with the goal of decreasing denials, enhancing performance and increasing reimbursement for the health system.
• Liaison for all government and commercial payer appeals.
• Coordinates the appeals process, job aides and workflows
• Participates in data gathering and analysis of reports regarding appeal activity
• Prepares for appeals audits
• Monitors QI (Quality Improvement) activities of appeals department
• Assists in the development of department flows and implementations
• Maintains all documentation associated with the processing and handling of appeals to comply with regulatory standards and timeframes.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed