[New Job Opening] Clinical Documentation Specialist job Vacancy in Sacramento, CA

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Job Details:
Position Name :
Clinical Documentation Specialist
Sacramento, CA
Job ID :
Description : Position Overview:
This position is eligible to work from home in the following states: Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Missouri, Montana, Nevada, North Carolina, Oregon, Tennessee, Texas, Utah.
The Ambulatory Clinical Documentation Specialist (CDS) uses strong clinical experience and knowledge to facilitate complete and specific prospective clinical documentation validations reviews in the medical record, reflecting the patient’s accurate clinical picture prior to the patient’s encounter. They are also responsible for retrospective clinical validation reviews which involves extensive record review, interaction with physicians, allied health professionals, clinical quality coding professionals, and medical office staff. The CDS assists the organization by utilizing a concurrent review process to promote on-going assessment of chronic conditions and quality in the medical record. This includes Hierarchical Condition Category according to regulatory compliance set forth by Centers for Medicare and Medicaid Services (CMS). This process will be applied to all Medicare Advantage and Commercially Risk Adjusted professional fee encounters in the inpatient and ambulatory environments. Medical Record review prioritization is based on data received from the Ambulatory Quality Reporting System in concert with the Engagement and Care Improvement Team and the Ambulatory Quality teams, that will risk rate the patients based on a variety of data points including but not limited to the number of reported HCCs, individual RAF Scores, evaluation of HEDIS measures etc. The CDS positions support the system-wide Comprehensive Health Assessment and Quality programs program and will provide service to all Medical Foundations within Sutter Health. This is a remote position.
HS Dipolma required
Associates Degree required
Bachelors Degree preferred
Licensures and Certifications
Registered Nurse (RN), Doctor of Medicine (MD), Doctor of Osteopathy (DO) or foreign trained physician required upon hire
5+ years in adult acute care nursing experience preferred
3-5 years previous Ambulatory or Inpatient CDI experience required
Skills and Knowledge
Knowledge of Pathophysiology and Disease Processes
Knowledge of Federal regulatory rules regarding documentation and coding specific to Risk Adjustment or Hierarchical Condition Category documentation and coding
Working Knowledge of ICD-10-CM
Strong organizational and analytical abilities
Dependable with a demonstrated ability to efficiently and independently manage own time and tasks with minimal supervision
Willingness to act and dress in a professional manner at all times
Able to manage multiple priorities and meet productivity targets
Critical thinking, problem solving and deductive reasoning skills
Computer skills – familiarity with Windows based software programs, including Microsoft Office products
Familiarity with electronic health records
Ability to understand and communicate differences between Medicare Part B guidelines and Medicare Advantage and Risk Adjustment Coding how they impact Hierarchical Condition Category assignment
Organization:Sutter Health System Office
Employee Status: Regular
Benefits: Yes
Position Status: Non-Exempt
Union: No
Job Shift: Day
Shift Hours:8 Hour Shift
Days of the Week Scheduled:Monday-Friday
Weekend Requirements: Other
Schedule: Full Time
Hrs Per 2wk Pay Period:80
Applications Accepted:All Applications Accepted
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