Provides clinically based concurrent review of patient medical records to ensure documentation accurately reflects the level of clinical services, severity of illness, and specificity of care. Works closely with physicians, nursing staff, medical records coding staff, compliance specialists, and other healthcare providers to ensure clinical information in the medical record is accurate and complete so appropriate utilization, clinical severity, outcomes, quality, and compliant reimbursement are captured for the level of service rendered.
Requirements & Qualifications
Experience
- Minimum of 3 years of healthcare experience required
- Strong medical/surgical background
- Coding, DRG, billing, auditing, and reimbursement experience preferred
- Clinician preferred with CDIP, CCDS, or CCS credential
Education
- Bachelor's degree in a healthcare field required
Licenses / Certifications
- One active certification/license required: CDIP, CCDS, or CCS
- Preferred: RHIT, RHIA, or active RN license
Skills and Knowledge
- Knowledge of clinical documentation strategies, hospital-acquired conditions, present on admission indicators, and core measures
- Knowledge of medical terminology, procedures, applicable laws, ICD-9, ICD-10, MS-DRGs, documentation compliance standards, and coding guidelines
- Understanding of healthcare delivery systems, utilization review, case review, and quality improvement practices
- Experience with chart review, electronic medical records, and clinical documentation software
- Strong communication, organizational, analytical, and problem-solving skills
- Proficiency with MS Office, including Word, Excel, Outlook, and PowerPoint
- Cerner Millennium EMR and 3M CDI Software experience preferred
- Regulatory background and DRG reimbursement knowledge preferred
Benefits & Perks
Compensation and Benefits
- Health insurance
- Dental coverage
- Vision coverage
- Retirement savings plan
- Flexible spending account
- Paid time off
- Holidays
- Tuition reimbursement
Location
New York, US
Employment Type
Full-time
Experience Level
Intermediate Level
Salary Range
$100,287 - $138,980
Remote work allowed
No
Posted
1 month ago
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