Job Locations US-Hazard

Requisition ID

2024-32140

# of Openings

1

Category

Business Professional

Community

System-Hazard

Posted Date

3 days ago(10/22/2024 1:44 PM)

Position Type

Regular Full-Time

Department

Coding

Shift

Day Shift

The Outpatient Clinical Documentation Specialist is responsible for following the outpatient facility processes and

providing clinically based reviews of documentation to capture accurate charges for services rendered.

See Job Description

The goal of concurrent review includes facilitation of appropriate physician documentation of care

delivered to accurately reflect patient severity of illness, risk of morality and care provided. Specific

reviews are both determined internally and by requirements/requests of external payers or regulatory

agencies and play a significant role in reporting quality of care outcomes and in obtaining accurate and

compliant reimbursement for acute care services.

Duties include:

Conduct chart reviews of Clinical departments daily to regularly review the documentation and chargeaccuracy and to integrate into educational sessions with the Clinical departments and medical staff

Performs review of accounts identified as potentially missing charges and conducts additional research to help resolve the areas of opportunity and identify the root cause of the issues causing the missed charges

Provides reporting and feedback to the Clinical Departments based on claim accuracy and chart reviews to encourage greater understanding and ownership of documentation and charge accuracy

Maintains current knowledge of applicable regulatory standards, which may impact utilization of processes and systems

Demonstrates creativity and enthusiasm while pursuing the goals of the department and the organization

Provides education to providers and other staff as deemed appropriate

Maintains the ability to be flexible and prioritizes daily responsibilities

Attends meetings, educations sessions and trainings as scheduled

Maintains strict confidentiality of all patients, employee and physician information according to HIPAA guidelines All other duties as assigned

Education

 Bachelor’s, or Associate’s Degree in Nursing or Health Information Management or related field

Minimum Work Experience

 Minimum of 5 years of clinical experience in an acute care setting or of 5 years experience in coding in an acute hospital setting

Required Licenses/Certifications

 RN, BSN, RHIA or RHIT credential required

Required Skills, Knowledge, and Abilities

· Knowledge of care delivery documentation systems and related medical record documents.

· Knowledge of age-specific needs and the elements of disease processes and related procedures.

· Strong broad-based clinical knowledge and understanding of pathology/physiology of disease processes.

· Excellent written and verbal communication skills.

· Excellent critical thinking skills.

· Demonstrated good nurse-physician relationships in the past and has the ability to maintain those going forward.

· Working knowledge of outpatient criteria.

· Ability to work independently in a time-oriented environment.

·Computer literacy and familiarity with the operation of basic office equipment.

· Assertive personality traits to facilitate ongoing physician communication.

· Ability to stand and walk for periods of time is required in the performance of job responsibilities.

· Working knowledge of Medicare reimbursement system and coding structures preferred, but not required.

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