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Job Details:
Position Name : Clinical Documentation Improvement Specialist
Location: Remote
Job ID : 093e6777b9d85b3b
Description : Description
UPMC Corporate Revenue Cycle is hiring a Clinical Document Improvement Specialist to join our team! This position will work remotely during daylight business hours.
The Clinical Documentation Improvement Specialist (CDS) facilitates modifications to clinical documentation through concurrent interaction with physicians and other members of the health care team to support that appropriate clinical severity is captured for the level of services rendered to all inpatients. If you have prior experience in nursing and coding, this could be the opportunity for you! Apply today to be considered.
Responsibilities:
Participating at the organizational level in clinical documentation improvement initiatives
Communicate with physicians, face-to-face or via clinical documentation inquiry forms, regarding missing, unclear or conflicting medical record documentation to clarify the information, obtain needed documentation, present opportunities, and educate for appropriate identification of severity of illness
Preparing trended data for presentation one-on-one and small to medium groups of physicians
Demonstrate an understanding of complications, co-morbidities, severity of illness, risk of mortality, case mix, secondary diagnosis, impact of procedures on the final DRG, and an ability to impart this knowledge to physicians and other members of the healthcare team
Be responsible for the day-to-day evaluation of documentation by the Medical Staff and healthcare team
Provide daily clinical evaluation of the medical record including physician and clinical documentation, lab results, diagnostic information and treatment plans
Qualifications
Three years of previous clinical acute care nursing experience medical/surgical experience to include critical care in conjunction with an expanded knowledge of DRG’s; OR completion of Health Records Administration program (RHIA) or Accredited Record Technician (RHIT) AND three years of experience with the Prospective Payment System and DRG selection; OR specific knowledge as a consultant in Medical Record coding and DRG assignment required.
Prior CDI work experience preferred.
Knowledge of computer technology, quality assurance activities, DRG, Quality Insights/Utilization review background is highly preferred.
Ability to communicate with staff, physicians, healthcare providers, and other health care system personnel in a professional and diplomatic manner required.
Licensure, Certifications, and Clearances:
Certified Coding Specialist (CCS) OR Certified Registered Nurse Practitioner OR Doctor of Medicine (MD) OR Doctor of Podiatric Medicine OR Registered Health Information Administrator OR Registered Health Information Technician (RHIT) OR Registered Nurse (RN)
UPMC is an Equal Opportunity Employer/Disability/Veteran
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