Network CDI Physician Champion

Job Summary :

The Physician Champion is responsible for developing positive relationships with both employed and affiliated medical staff members in order to fulfill strategic business growth and objectives.

This position plays an important role in partnership with Senior Network CDI Director in ensuring physician support and execution of Documentation strategies and processes.

The Physican Champion will provide clinically based concurrent review of patient medical records to ensure documentation accurately reflects the level of clinical services, severity of illness and specificity of care.

Responsibilities :

Establish a mechanism for concurrent review of inpatient medical records for accuracy and adequacy of physician documentation

Create an environment which fosters the enhancement of communication within the medical record.

Improve the education and competence of Coding validators for their interpretation of clinical pathophysiology and physician documentation.

Support the hospital’s overall compliance efforts designed to assure the accuracy of diagnosis coding, procedural coding, DRG assignment, risk adjusted severity and mortality reporting.

Establish and maintain a review and accurate reporting process of :

• PSI Reviews
• HAC Reviews
• Risk adjustment Score
• Elixhauser Reporting / Coding
• Maintains awareness of the continual changes in federal and state regulations for prospective payment;
• Communicates with and educates members of the patient care team and clinical documentation team on an ongoing basis;
• Along with Senior Networ CDI Director serves as resource to physicians and other members of the healthcare team in matters relating to published DRG, SOI / ROM, ICD-10 and PCS information;

Facilitates ongoing education of staff in relation to chart documentation improvement techniques and practices

Assists with physician engagement by establishing strategies for broader physician understanding of the CDI program and its importance.

Coordinates with program leadership to provide a summary of results at physician / medical staff meetings. Engages in one-on-one discussions with physicians needing further buy-in and support by providing specific data and case examples.

Supports the organizational Quality goals and objectives through CDI improvements. Coordinates with the CDI team provide clinical documentation education to the medical staff.

Partners with CDI leadership on an approach and plan for physician responses to queries, including physician escalation assistance

• Full Performance Knowledge, Skills, Abilities and Attributes : Thorough knowledge of clinical documentation strategies and hospital-acquired conditions / present on admission and core measures;
• through knowledge of medical terminologies, procedures and applicable laws to collect and evaluate medical documentation;
• thorough knowledge of ICD-10, MS-DRGs, documentation compliance standards and coding principles and guidelines; good knowledge of healthcare delivery system, utilization review, case review and quality improvement practice and theory;
• skill in reviewing charts and utilizing electronic medical record and clinical documentation program; ability to communicate effectively and diplomatically within a multi-functional team which includes physicians, other members of the allied healthcare team and HIM coders;
• strong organizational, planning and observation skills; attention to detail; analytical-critical thinking and problem solving skills;
• excellent written and verbal communication; excellent computer skills and knowledge of software for database maintenance and electronic health record storage;
• ability to establish and maintain effective working relationships with all levels of medical, nursing, and non-professional staff;

resourcefulness; flexibility; assertiveness; initiative; tact; creativity; thoroughness; sound professional judgment; physical condition commensurate with the demands of the position.

Qualifications / Requirements :

Experience :

5 years recent experience in Clinical Practice Required

Required minimum experience : Minimum of three years of healthcare experience required, strong medical / surgical background.

Experience with Coding / DRG, billing, auditing and reimbursement is preferred. Clinician preferred with a CDIP / CCDS / CCS credential.

Required minimum skills : High level of interpersonal and communication skills necessary to establish rapport with physicians and other healthcare providers.

MS Office (Word, Excel, Outlook, and PowerPoint) knowledge is expected. Chart review experience required. Cerner Millennium Electronic Medical Record and 3M CDI Software experience is preferred.

Regulatory background and DRG reimbursement knowledge preferred.

Education :

Graduated from an accredited Medical School, required.

Licenses / Certifications :

Required minimum Licensure / Certification : At least one of the following active certification / licenses required :

• CDIP : Clinical Documentation Improvement Practitioner
• CCDS : Certified Clinical Documentation Specialist
• CCS : Certified Coding Specialist, or equitable coding credential

PI254011705