Professional Fee Clinical Documentation Specialist

Professional Fee Clinical Documentation Specialist

Requirements

• Minimum associate degree
• Licensure / Certification: CCS-P, CPC, CRC, CCDS or other coding credential required
• RN or LPN preferred
• Three (3) years’ experience in hospital or outpatient healthcare setting, preferred
• Coding experience highly preferred
• Extensive clinical knowledge and understanding of pathophysiology
• Strong critical thinking skills and utilization of clinical knowledge to identify potential clinical indicators supporting patient acuity and clarifications of the medical record
• Excellent written and verbal communication skills
• Possesses strong project management skills
• Possesses strong interpersonal skills, with demonstrated success at communicating effectively with all levels of the organization
• Demonstrates skilled ability and comfort with electronic medical records (Epic preferred)
• Proficient with personal computer applications (Excel, Word, and Power Point)

Responsibilities

• Completing pre-visit and post-claim reviews
• Providing clear communication and education to providers on their documentation, coding and billing practices
• Identifying documentation opportunities for the provider to recapture previously documented HCCs diagnoses or new ‘suspect conditions’
• Focusing on E/M encounters and highlighting opportunities based on a provider’s medical decision making and the patient’s acuity
• Coordinating with colleagues from the CDI Program or other members of the organization regarding education and training
• Using performance and outcome data from third-party support or other sources to identify high priority providers
• Creating specialty-specific education on relevant topics as identified in data analytics and from clinical encounter reviews and post-claim education chart reviews
• Developing and maintaining a systematic education schedule and approach for providers
• Delivering ongoing feedback and education to communicate importance of complete documentation

Preferred Qualifications

• Three (3) years’ experience in hospital or outpatient healthcare setting, preferred
• Coding experience highly preferred
• RN or LPN preferred