The Denver Hospice has an opening for an RN Clinical Documentation Specialist.
Location: Denver, CO
Status: Full-time
Schedule: Monday-Friday, 8-5
Pay Range: $80,288 - $94,328 annually
Supplemental Pay: Based on position, schedule and/or availability: Stipends/Shift Diffs/Paid Mileage
Mileage and Expense Reimbursement: Sixty-two and a half cents per mile - one of the highest in the industry!
REWARDING WORK YOU WILL DO:Responsible for reviewing patient medical records to ensure they meet clinical, regulatory, and billing compliance standards. This role combines clinical expertise with a deep understanding of healthcare regulations, including those from the Centers for Medicare and Medicaid Services (CMS).
- Conducts thorough reviews of clinical documentation during the patients' stay, often within 24-48 hours of admission, such as patient charts, care plans, and physician's orders, to ensure they are complete, accurate, and support the patient's initial and ongoing eligibility for hospice services.
- Identifies missing, vague, or conflicting documentation regarding a patient's condition and treatment and works closely with physicians and other providers to gain clarity or obtain additional information.
- Verifies that all records and billing practices adhere to applicable federal and state regulations, including CMS and HIPAA standards.
- Analyzes audit findings to identify trends and patterns in documentation quality. Generates quality reports and presents findings to clinical staff and leadership to facilitate continuous improvement.
- Educates clinicians and other staff on proper documentation procedures, compliance essentials, and best practices. May help develop training materials for staff development.
- Assists in preparing for internal and external audits, including those from regulatory bodies like the Office of Inspector General (OIG), Accreditation Commission for Health Care (ACHC) & Colorado Department of Public Health and Environment (CDPHE).
- Ability to critically appraise hospice patient charts and determine if they are in compliance.
- Translate audit findings and trends into organizational improvement activities.
- Create and deliver educational offerings, team member coaching, etc., from chart findings to drive improvement.
WHAT WE ARE GOING TO LOVE ABOUT YOU:- Graduate of an accredited school of nursing.
- 5 years' experience in hospice or home health medical record review, medical terminology, and relevant regulations, including Medicare and Medicaid rules is preferred.
- 2 years' experience with electronic health records (EHRs) and auditing software is necessary. Proficiency with basic computer programs, including the Microsoft Office suite, is also required.
- Excellent written and verbal communication skills are critical for reporting findings and providing feedback to staff.
- Strong analytical and critical-thinking skills are needed to research complex coding and compliance issues.
- Current Colorado RN license or a license from the state of primary residence, if participating in the NLC (Nurse Licensure Compact). OASIS D and ICD-10 certification is preferred but may be substituted for actual hands-on experience.
PHYSICAL REQUIREMENTS:- Ability to lift/carry a minimum of 30 lbs.
