Coord, Clinical Documentation Quality

BJC HealthCare • St. Louis, MO

7d

About The Position

BJC HealthCare is seeking a Clinical Documentation Quality Coordinator to join their team. The Documentation Quality Coordinator (DQC) works at the enterprise level and uses their extensive Clinical Documentation Improvement (CDI) experience to perform second level reviews of complex clinical cases and focused reviews of target case populations prior to final coding and billing across BJC. This position responds to review requests from across the system and escalates unanswered queries to Physician Champions. This position also analyzes data & reports and educates facility-based CDI staff and medical providers on hospital/enterprise level trends and areas of opportunity.

Requirements

• Bachelor's Degree in Nursing
• 5-10 years of experience
• Clinical Documentation certification
• RN license

Nice To Haves

• Master's Degree in Nursing
• Certified Coding Specialist
• Certified Documentation Improvement Practitioner
• Certified Revenue Cycle Representative

Responsibilities

• Reviews clinical documentation to facilitate the accurate representation of the severity of illness, expected risk of mortality, and complexity of care by improving the quality of the physician’s clinical documentation; performs retrospective reviews for DRG verification according to the OIG (Office of Inspector General) workplan and Centers for Medicare and Medicaid Services (CMS), noting organizational trends or patterns.
• Demonstrates a thorough understanding of the MS-DRG system, CCs/MCCs, impact on quality, and CMI as well as ICD-10 coding systems and the guidelines related to clinical documentation improvement; serves as a resource for the clinical documentation improvement specialist team.
• Leads provider engagement, establishes standards, relationships and maintenance for shared accountability related to enterprise CDI and documentation improvement efforts, with all providers across the enterprise.
• Identifies enterprise trends, variances, deficiencies, and problems utilizing aggregated data and information as part of the integrated clinical documentation improvement program; performs provider and group level CDI data trend analysis, issue identification and solution proposal to leadership.
• Leads and manages ongoing documentation improvement initiatives across service lines and across hospitals including formal and informal education plans related to clinical documentation improvement; leads enterprise functional teams for education, standard queries, standard process & technology, analytics, etc.; acts as a consultant to quality managers, management team, medical staff and health care staff regarding core measure performance and clinical documentation opportunities; leads and/or participates in hospital(s) and organization projects related to documentation improvement; coordinates and collaborates with enterprise CDI for standards in content, process, and technologies.

Benefits

• Comprehensive medical, dental, vision, life insurance, and legal services available first day of the month after hire date
• Disability insurance paid for by BJC
• Annual 4% BJC Automatic Retirement Contribution
• 401(k) plan with BJC match
• Tuition Assistance available on first day
• BJC Institute for Learning and Development
• Health Care and Dependent Care Flexible Spending Accounts
• Paid Time Off benefit combines vacation, sick days, holidays and personal time
• Adoption assistance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level