The Risk Adjustment Clinical Documentation Specialist facilitates accurate, complete, consistent and timely documentation for severity of illness and quality in medical records completed in the physician office setting. This involves extensive record review, interaction with physicians, advanced practitioners, health information management professionals, nursing staff and other physician office staff
JOB DUTIES AND RESPONSIBILITIES:
Review medical record(s) for completeness, accuracy, consistency and clinical evidence for severity of illness (appropriate capture of true disease burden and quality using official Risk Adjustment and relevant official documentation/coding guidelines.
Accurate, comprehensive and timely medical record review.
Consistent and effective use of Compliant Documentation Management Program (CDMP) Risk Adjustment strategies.
Recognize opportunities for documentation improvement.
Formulate clinically credible documentation clarifications.
Request documentation clarifications as appropriate for severity of illness.
Effective and appropriate communication with Providers.
Timely follow up on all cases and resolution of those with clinical documentation clarifications.
Provide routine formal and informal (just-in-time) Risk Adjustment and documentation improvement education to providers/staff.
Participate in Risk Adjustment steering committee meetings.
PHYSICIAL AND SENSORY REQUIREMENTS:
Requires sitting, standing and walking for extended periods of time (up to 8 hours at a time). Requires continual use of fingers for writing and computer entry. Routine use of upper extremities; occasional requirement to lift up to 25 pounds. Regularly requires ability to stoop, bend and reach above shoulder level. Requires ability to hear normal conversation and good general, near and peripheral vision.
EDUCATION:
Graduation from a nursing program, and a BSN preferred. Certified Professional Coder (CPC) and a Certified Risk Coder (CRC) required. Current state Registered Nursing License preferred.
TRAINING AND EXPERIENCE:
5 years of adult acute or ambulatory care experience in med/surg or physician office setting with both CPC and CRC coding credentials required. One year of Clinical Documentation Improvement (CDI) experience.
Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!!
St. Luke's University Health Network is a regional network of hospitals, physicians and other related organizations providing care primarily in Lehigh, Northampton, Monroe, Carbon, Schuylkill, Bucks, Montgomery and Berks counties in Pennsylvania and Warren County in New Jersey.
The Network provides services at more than 150 sites. St. Luke's University Health Network is comprised of six hospital sites. The Network includes:
Areas of exceptional medical expertise include:
St. Luke's offers an exceptional benefit plan for employees. Our values are reflected in all we do for patients, each other and the community:
Pride - We take pride in our accomplishments and in our organization.
Caring - We show consideration for others and their feelings. We treat others as we want to be treated.
Respect - We recognize the value, diversity and importance of each other, those we serve and the organization.
Accountability - We are responsible to make decisions and solve problems in a timely and effective manner.
Flexibility - We adapt to the changing needs and expectations of those we serve.
Teamwork - We work together to improve quality.
The mission of St. Luke's University Health Network is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.