Description
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Summary:
The Clinical Documentation Specialist (RN) utilizes nursing expertise to ensure maximum reimbursement for services rendered in an inpatient hospital organization. By pursuing accurate inpatient coding and Diagnosis-Related Group (DRG) assignments through auditing and analysis, the CDS RN Specialist ensures optimal payer reimbursements.
Responsibilities:
- Collaborates with Care Coordinators in Clinical Care Management to review inpatient records for accurate diagnosis and procedural coding. Ensures correct provisional (while patient is hospitalized) and final (patient discharge) Diagnosis-Related Group (DRG) coding assignment.
- Identifies cases for Physician Advisor intervention. Coordinates Physician Advisor reviews and collects review statistics, ensuring compliance with departmental and regulatory agency guidelines.
- Communicates with physicians, care managers, coders, and other healthcare team members to facilitate comprehensive medical record documentation to reflect clinical treatment, decisions, and diagnoses for inpatients.
- Develops physician education strategies to promote complete and accurate clinical documentation and correct negative trends. Demonstration of knowledge of DRG payer issues, documentation opportunities and coding guidelines.
- Monitors and analyzes effectiveness of changes in coding and DRG assignments in terms of reimbursement outcomes. Identifies which coding/DRG assignments could benefit from physician advisor reviews.
PARDEE
Other information:
Qualifications
Required
- Must be licensed to practice as a Registered Nurse in the state of North Carolina or one of compact states.
- Two (2) years of experience working as a registered nurse (RN) in an acute care setting
- Strong verbal and written communication
- Basic Life Support (BLS) certification
Preferred
- Certification as a Clinical Documentation Integrity Practitioner (CDIP) as issued by American Health Information Management Association (AHIMA)
- Experience working in a care management capacity
- Certification in Care Management
01.9615.1540
Job Details
Legal Employer: Pardee - HCHC
Entity: Pardee UNC Health Care
Organization Unit: Health Information Management
Work Type: Full Time
Standard Hours Per Week: 40.00
Work Assignment Type: Remote
Work Schedule: Day Job
Location of Job: PARDEEHOSP
Exempt From Overtime: Exempt: No