Clinical Specialist Jobs

About The Position

Requirements

• Required associate degree with a preferred bachelor's degree
• Four years of healthcare experience will substitute for the required associate degree
• Required Licenses and Certifications (one of the following): CPC - Cert-Cert Professional Coder American Academy of Professional Coders (AAPC), CCDS DOC - Cert-Cert Clinical Doc. SPCLST Association of Clinical Documentation Improvement Specialist (ACDIS), CDIP - Cert-Clinical Doc. Impr. PROF American Health Information Management Association (AHIMA), CCS-P - Cert-CCS-P Physician Based American Health Information Management Association (AHIMA), CIPC - Certified Inpatient Coder American Academy of Professional Coders (AAPC), COC - Certified Outpatient Coder American Academy of Professional Coders (AAPC), CDEO Certified Documentation Expert Outpatient American Academy of Professional Coders (AAPC), CCDS-O Certified Clinical Documentation Specialist Outpatient Association of Clinical Documentation Improvement Specialist (ACDIS)

Nice To Haves

• Preferred Pediatric Experience

Responsibilities

• Develops and implements a method by which each TCPA & TCPSO physician has a representative sample of his/her medical records reviewed on a routine and frequent basis.
• Provides feedback to physician and Director on the educational opportunities found from the reviews. Recommends improvement opportunities to documentation practices and coding changes to physician based on information.
• Provides feedback to the Director on any Medicaid compliance issue found from the reviews.
• Develops and implements training programs for Physicians, Front Office, and CBO staff to reinforce and/or change the documentation and coding behaviors found from the review.
• Educates and reinforces the most appropriate documentation used to optimize quality and reimbursement that TCPA & TCPSO physicians utilize. Where appropriate, this should include education on coding guidelines were quality documentation is already present but not coded to the appropriate level.
• Focused on root cause identification and process improvement specific to documentation accuracy and completeness.
• Engages in process and quality improvement initiatives.
• Reviews and interprets the Federal Registry and other relevant publications on a current and regular basis to be aware of coding changes that may affect TCPA & TCPSO as well as the industry.
• Responds directly to all telephone and written requests for documentation and coding information accurately and timely.
• Acts as a risk adjustment documentation and coding resource, including education and physician engagement.