Clinical Reviewer, Diagnosis Accuracy

HealthPartners • Bloomington, MN

4h • Onsite

About The Position

This highly skilled clinician position supports the ongoing work of the Diagnosis Accuracy Program. The individual will be responsible for reviewing patient records to assess diagnosis code specificity, identifying documentation and coding opportunities based on supporting clinical evidence, and validating suspect conditions.

Requirements

• Advanced Practice Clinicians either Master of Science in Nursing degree (Nurse Practitioner), Physician Assistant (PA), or Registered Nurse (RN) with clinical coding experience
• Minimum two years clinical experience
• Maintain a current, active, unrestricted state licensed/certification as a Nurse Practitioner (NP), Physician Assistant (PA), or Registered Nurse
• Strong clinical background with in-depth knowledge of medical terminology, pathophysiology, pharmacology, and disease interactions, supported by sound clinical judgment and ability to interpret complex medical information
• Strong and demonstrated PC skills are required along with an ability to learn new systems
• Experience with electronic medical record and billing modules (e.g. Epic)
• Strong verbal, and written communication, skills
• Ability to work with others and develop consensus among differing parties
• Knowledge of ICD-10 diagnosis coding, clinical documentation requirements, and clinical documentation improvement concepts
• Ability to self-direct work, detail orientated and organized
• Ability to manage and impart confidential information

Nice To Haves

• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS-P) Certification
• AHIMA accredited Registered Health Information (RHIT) or Registered Health Information Administer (RHIA)
• Certified Documentation Expert – Outpatient (CDEO)
• Certified Risk Coder (CRC) certification
• Certified Clinical Documentation Specialist – Outpatient (CCDS-O)
• Knowledge of multiple payment and risk adjustment methodologies used by government and commercial payers
• Ability to work collaboratively with others
• Ability to work in an ever-changing environment with differing perspectives and ability to resolve situations effectively

Responsibilities

• Review patient records to assess diagnosis code specificity
• Identify documentation and coding opportunities based on supporting clinical evidence
• Validate suspect conditions

Benefits

• Medical insurance
• Dental insurance
• Retirement program
• Time away from work
• Insurance options
• Tuition reimbursement
• Employee assistance program
• Onsite clinic
• Comprehensive range of benefits to support every aspect of your life, including health, time off, retirement planning, and continuous learning opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 101-250 employees