CLINICAL DOC SPECIALIST PROFESSIONAL FEE

Position summary :

The Clinical Documentation Specialist (CDS), Professional Fee will serve as an advisor and expert resource for providers to improve the accuracy of clinical documentation to support patient complexity, risk profiles and appropriate E / M levels thereby supporting the provider’s efforts and their billing.

The CDS primarily assist providers in identifying clinically relevant information and capturing the clinical documentation needed to accurately reflect patient acuity. The CDS will focus on highlighting opportunities based on the provider’s medical decision making to appropriately reflect the level of service provided for patient care.

The CDS will be responsible for completing post-claim reviews as well as providing clear communication and education to providers on their documentation, coding and billing practices, in adherence to compliance standards set by governing entities such as CMS, AHA, etc.

Post-claim reviews focus on E / M encounters and highlight opportunities based on a provider’s medical decision making and the patient’s acuity to support appropriate and accurate E / M level assignments as well as any Hierarchical Condition Categories (HCCs) identified

The CDS will also coordinate with colleagues from the CDI Program or other members of the organization regarding education and training geared towards improving clinical documentation based on findings from post-claim reviews

MINIMUM QUALIFICATIONS

Education : Associates degree required. In lieu of degree, at least five (5) experience as a medical coder may be considered.

Required length and type of experience :

• Five (5) years of experience as a medical coder
• 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
• Ability to work independently in a time-oriented environment
• Demonstrates skilled ability and comfort with electronic medical records (Cerner preferred)
• Proficient with personal computer applications (Excel, Word, and Power Point)
• Ability to build education material that is meaningful for providers and team members
• Strong problem solving and investigative skills

Required licensure, certification or registry : CCS-P, CPC, CRC, or other coding credential; RN or LPN preferred but not required

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