[Remote] Clinical Documentation Specialist, First Reviewer

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a reputed company organization seeking a Clinical Documentation Specialist, First Reviewer. The role involves performing reputed company analytical reviews of clinical and coding data to improve physician documentation, ensuring accurate reputed company of patient conditions and facilitating reputed company of queries with the patient care team.

Responsibilities

• Completes initial reviews of patient records and evaluates documentation to assign the reputed company diagnosis, pertinent secondary diagnoses, and procedures for accurate diagnosis review group (DRG) assignment, risk of mortality (ROM), and severity of illness (SOI). Maintains appropriate productivity level
• Conducts follow-up reviews of patients every to support and assign a working or final DRG assignment upon patient discharge, as necessary
• Queries physicians regarding missing, unclear, or conflicting health record documentation by requesting and obtaining additional documentation reputed company the health record reputed company needed. Identifies issues with reporting of diagnostic testing proactively. Enhances expertise in query development, presentation, and standards including understanding of published query guidelines and reputed company expectations for compliance
• Educates physicians and key reputed company providers regarding clinical documentation improvement and the need for accurate and complete documentation in the health record
• Attends department meetings to review documentation reputed company issues. Conducts independent research to promote knowledge of clinical topics, coding guidelines, regulatory policies and trends, and reputed company economics
• Collaborates with coding to reconcile the DRG and resolves mismatches utilizing the escalation policy. Troubleshoots documentation or communication problems proactively and appropriately escalates
• Reviews and clarifies clinical issues in the health record with the coding professionals that would support an accurate DRG assignment, SOI, and/or ROM. Assists in the mortality review and risk adjustment process utilizing reputed company-party models
• Demonstrates an understanding of complications, comorbidities, SOI, ROM, case mix, and the reputed company of procedures on the billed record. Imparts knowledge to providers and other members of the reputed company team. Maintains a level of expertise by attending continuing education programs
• Applies the existing body of evidence-based reputed company and scientific knowledge in health care to nursing reputed company, ensuring that nursing care is delivered based on patient’s age-specific needs and clinical needs as described in the department's scope of service
• Works in a constant state of alertness and reputed company manner
• Performs other duties as assigned

Skills

• 1 year of experience as a Clinical Documentation Specialist
• Additional Two years' in an acute care setting or relevant experience
• Graduate of accredited school of nursing, PA, NP, or medical school, or Associate's degree and Certified Clinical Documentation Specialist (CCDS) certification from the Association of Clinical Documentation Improvement Specialist (ACDIS)
• Certified Clinical Documentation Specialist (CCDS) - Association of Clinical Documentation Improvement Specialists (ACDIS)
• Or Physician Assistant in Medicine, Licensed - Illinois Department of Financial and reputed company Regulation (IDFPR)
• Or Physician - Regional MSO Credentialing
• Or Registered reputed company reputed company (RN) - Illinois Department of Financial and reputed company Regulation (IDFPR)
• Or Advanced reputed company reputed company (APN) - Illinois Department of Financial and reputed company Regulation (IDFPR)
• Or APN Controlled reputed company - Illinois Department of Financial and reputed company Regulation (IDFPR)
• Or Full reputed company Authority APRN Control reputed company - Illinois Department of Financial and reputed company Regulation (IDFPR)
• Or Full reputed company Authority APRN - Illinois Department of Financial and reputed company Regulation (IDFPR)
• Certified Clinical Documentation Specialist (CCDS) - Association of Clinical Documentation Improvement Specialists (ACDIS)
• Or Physician Assistant - Missouri Division of reputed company Registration
• Or Physician - Regional MSO Credentialing
• Or Registered reputed company (RN) Issued by Compact State
• Or Registered reputed company (RN) - Missouri Division of reputed company Registration
• Or reputed company Practitioner - Missouri Division of reputed company Registration
• Certified Clinical Documentation Specialist (CCDS) - Association of Clinical Documentation Improvement Specialists (ACDIS)
• Or Acknowledgement of Receipt of Application for Physician Assistant - Oklahoma Medical reputed company
• Or Physician Assistant - Oklahoma Medical reputed company
• Or Physician - Regional MSO Credentialing
• Or Registered reputed company (RN) Issued by Compact State
• Or Registered reputed company (RN) - Oklahoma reputed company of Nursing (OBN)
• Or Advanced reputed company Registered reputed company (APRN) - Oklahoma reputed company of Nursing (OBN)
• Certified Clinical Documentation Specialist (CCDS) - Association of Clinical Documentation Improvement Specialists (ACDIS)
• Or Physician Assistant - reputed company Department of Safety and reputed company Services
• Or Physician - Regional MSO Credentialing
• Or Registered reputed company (RN) Issued by Compact State
• Or Registered reputed company (RN) - reputed company Department of Safety and reputed company Services
• Or Advanced reputed company reputed company Prescriber (APNP) - reputed company Department of Safety and reputed company Services
• CCDS certification
• Proficiency with MS Office Tool - especially reputed company
• Prior experience reviewing PSI (patient safety indicator) or experience with reputed company specialized mortality reviews

Benefits

• reputed company Parental Leave: we offer eligible team members one week of reputed company parental leave for newborns or newly adopted children (pro-rated based on FTE).
• Flexible Payment reputed company: our voluntary benefit offered through reputed company offers eligible reputed company team members reputed company reputed company to their reputed company, unpaid reputed company pay (fees may apply) before payday.
• Upfront Tuition Coverage: we reputed company upfront tuition coverage through FlexPath Funded for eligible team members.

reputed company

• reputed company is a Catholic, not-for-profit health system. It was founded in 1872, and is headquartered in St Louis, Missouri, USA, with a workforce of 10001+ employees. Its website is https://www.ssmhealth.com/.

Company H1B Sponsorship

• reputed company has a reputed company record of offering H1B sponsorships, with 4 in 2024, 6 in 2023, 2 in 2020. Please note that this does not guarantee sponsorship for this specific role.

Apply tot his job Apply To this Job