Clinical Document Specialist Senior

Corewell Health$80K — $95K *
US-AnywhereRemote in Grand Rapids, MI
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in nursing, health related field, or business administration
  • 5+ years of relevant clinical experience
  • State of Michigan RN, NP, or Physician Assistant license
  • Certified Clinical Documentation Specialist (CCDS) with 2 years of experience
  • Preferred Master's degree in a health-related field and clinical documentation review experience

Responsibilities

  • Conduct in-depth analysis of patient care documentation to ensure accurate coding and billing
  • Prepare detailed clinical summaries and documentation as needed
  • Analyze practices in patient care, documentation and billing to identify improvement areas
  • Develop and communicate solutions to physicians regarding documentation issues
  • Utilize project management to plan and implement quality improvement projects
  • Monitor data for quality and efficiency in patient care
  • Engage in continuous education to maintain professional competence

Benefits

  • Engagement in ongoing training and educational programs
  • Full-time employment with a Monday to Friday schedule
  • Opportunity to work within a dynamic clinical assurance program
  • Potential for professional development within health documentation and coding
Full Job Description
Job Summary

Conducts thorough analysis encompassing clinical review and assessment of patient records focusing on the documentation of the clinical condition and the care provided. Ensures that level of patient services provided is accurately and completely documented. Develops, communicates and implements solutions/programs to address problem areas identified through quality studies or claim denials working directly with physicians and other health care professionals.

Essential Functions
  • Works for the promotion of proper and ethical documentation and coding/billing activities, thus improving the organization's level of accurate reimbursement. Conducts in-depth analysis of documentation of clinical care rendered in inpatient and outpatient settings. Uses critical analysis to determine appropriate DRG or coding assignment, appropriate setting, medical necessity, coverage of experimental services, and clinically related visits. Ensures that services are provided in accordance with state and federal regulations, organizational policy and accreditation/compliance requirements.
  • Prepares detailed clinical summaries and/or other clinical documentation as necessary for role.
  • Analyzes current practices in the areas of patient care, documentation and coding/billing, utilizing observation and data/statistical analysis to identify areas of opportunity.
  • Develops and communicates recommended solutions/programs to address problem areas to physicians and other health care professionals. Communicates study or other findings and trains physicians and other healthcare professionals as required in current data and healthcare trends as it relates to appropriate clinical documentation and evidenced-based medicine.
  • Utilizing project management skills, identifies project scope, project requirements, decision points, timelines, and resource requirements for planning, prioritization, implementation, and evaluation of complex, multifaceted quality and patient safety decision support projects and programs.
  • Aids in the continuous monitoring of data for quality, cost effectiveness and efficiency. Engages in process and quality improvement activities.
  • Engages in continuous study of the entire professional field, including best practices, to maintain the professional competence, knowledge, and skills necessary for the satisfactory performance of all assigned responsibilities. Completes required continuous training and education, including department specific requirements.
  • Ensures that required documentation for activities within areas of responsibility is performed in an accurate and timely manner.


Qualifications

Required
  • Bachelor's degree in nursing, health related field or business administration
  • 5 years of relevant experience Clinical Role
  • LIC-Registered Nurse (RN) - STATE_MI State of Michigan
  • LIC-Nurse Practitioner (NP) - STATE_MI State of Michigan
  • CRT-Clinical Documentation Specialist, Certified (CCDS) - CCAP Department 2 Yrs
  • LIC-Physician Assistant - STATE_MI State of Michigan

Preferred
  • Master's degree in health-related field
  • Clinical Documentation Review experience

Primary Location
SITE - 1810 Wealthy St SE - Grand Rapids

Department Name
Concurrent Clinical Assurance Program - Corporate

Employment Type
Full time

Shift
Day (United States of America)

Weekly Scheduled Hours
40

Hours of Work
8:00 a.m. - 5:00 p.m.

Days Worked
Monday - Friday

Weekend Frequency
N/A

About Corewell Health

Corewell Health Careers

Joining Corewell Health presents an unparalleled opportunity to become part of a leading team of healthcare professionals dedicated to excellence. Corewell Health is renowned for its commitment to innovation, leadership, and providing superior healthcare services.

Explore Job Opportunities

Corewell Health is actively seeking talented individuals who are eager to contribute to a dynamic healthcare environment. The company offers a variety of job opportunities that cater to a range of skills and experiences. Whether you're a seasoned professional or a recent graduate, Corewell Health has a position that could be the perfect fit for your career ambitions.

Internship Programs

For those just starting their professional journey, Corewell Health provides robust internship programs designed to foster skills development and offer real-world experience in the healthcare industry. Internships at Corewell Health are a stepping stone to full-time employment and offer invaluable networking opportunities within the healthcare sector.

Growth and Development

Career growth is a cornerstone of employment at Corewell Health. The company supports its team members' professional development through comprehensive training programs, including leadership training and diversity training. These initiatives ensure that every team member has the tools and knowledge necessary to excel in their roles and advance within the company.

Benefits and Culture

Corewell Health is committed to creating a workplace culture that values diversity and inclusion. Employees enjoy a competitive package of benefits that supports both their professional and personal lives. The company's culture promotes teamwork and respect, making it an ideal environment for those who value collaboration and innovation.

Hiring Process

The hiring process at Corewell Health is designed to be transparent and efficient. Candidates are encouraged to submit a resume and may be invited for an interview to discuss their qualifications and career goals in more detail. Corewell Health values a thorough approach to ensure that all potential team members align with the company’s values and vision for the future.

Networking and Professional Development

Corewell Health believes in the power of networking and encourages its employees to engage with one another and the broader healthcare community. This engagement fosters a sense of community and collaboration, which is critical in the fast-paced world of healthcare.

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