Clinical Documentation Improvement Specialist (Part-Time -20 hours per week) Job

Children's Health - Health Information Careers

Job Number: 52050

Location: Dallas, TX

Date Posted: 7-16-2017

Description:

POSITION SUMMARY:

Facilitates and obtains appropriate provider documentation for clinical conditions and/or procedures to support the appropriate APR-DRG assignment, severity of illness, expected risk of mortality, and complexity of care provided to patients.

JOB SPECIFIC RESPONSIBILITIES:

  • Completes initial concurrent reviews of patient records for specified patient populations to evaluatedocumentation to assign working DRG, pertinent secondary diagnoses and procedures for accurate APR-DRG assignment, risk of mortality and severity of illness.
  • Queries physicians regarding missing, unclear, or conflicting health record documentation.
  • Educates physicians and providers regarding the need for accurate and complete documentation in the health record.
  • Partners with coding professionals to ensure accuracy of diagnostic and procedure data and completeness of supporting documentation to determine appropriate APR-DRG assignment.

EXPERIENCE:

  • Minimum 1-2 years of job related experience required.
  • Equivalent combination of education and/or experience in health information management, coding, or nursing preferred.

EDUCATION:

  • Two-year Associate's degree or equivalent experience required.
  • Four-year Bachelor's degree or equivalent experience preferred.
  • Degree in Nursing, Health Information Management, or related field preferred.

SPECIFIC KNOWLEDGE, SKILLS, AND ABILTIES:

  • Clinical knowledge and comprehension of anatomy, physiology, pharmacology, and medical terminology.
  • Ability to apply official ICD-9 coding and documentation guidelines.
  • Knowledge of APR-DRG reimbursement system.
  • Demonstrates effective interpersonal skills and possesses good oral and written communication skills.
  • Communicates effectively with physicians, nursing, health information management coding staff and ancillary staff.

LICENSES & CERTIFICATIONS

  • Registered Health Information Management Technician/Administrator preferred.
  • Registered Nurse preferred.

Physical Demands

  • Light - Exerting up to 20 lbs. occasionally, 10 lbs. frequently, or negligible amounts constantly and may require walking or standing to a significant degree.


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