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Clin Doc Integrity Spec I, Full-Time, Days

Prisma Health

Columbia, SC

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JOB DETAILS
SKILLS
Case Management, Certified Coding Specialist (CCS), Clinical Study Publications, Communication Skills, Computer Skills, Critical Care, Diagnosis-Related Group (DRG), Discharge Plans, Disease, Documentation, Health Information Management, Healthcare, Healthcare Common Procedure Coding System (HCPCS), Healthcare Providers, ICD-10, Medical Coding, Medical Records, Medical Treatment, Member Orientation, Nursing, Nutrition, Postanesthesia, Reconciliation, Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Registered Nurse (RN), Risk, Team Player
LOCATION
Columbia, SC
POSTED
Today
Inspire health. Serve with compassion. Be the difference.

Job Summary
Performs concurrent medical record reviews to facilitate the highest level of accuracy, quality, and completeness of provider documentation. This is accomplished by medical record review, query process, and reconciliation process. Responsible for assisting in maintaining a financially healthy, productive department, and promoting their own development with an emphasis on evidence-based practice education.

Job Description

Essential Functions
  • All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference.
  • Conducts concurrent medical record reviews of selected patient health records to address clarity, completeness, consistency and accuracy of clinical documentation.
  • Employs the query process as needed to provide accurate documentation reflective of patient's severity of illness, risk of mortality, comorbid conditions, length of stay, principal diagnosis, and present on admission (POA) status.
  • Completes the reconciliation process to ensure accurate coding reflective of patient's severity of illness, risk of mortality, comorbid conditions, length of stay, principal diagnosis, and present on admission (POA) status.
  • Develops and maintains supportive, collaborative relationships with providers and health care team members to include education and follow up.
  • Stay current with coding guideline changes, changes in treatment modalities, clinical disease indicators, and compliant query policies.
  • Serves as a resource for co-workers, providers, and other support departments (coding, case management, quality, nutrition, etc.)
  • Assigns a working DRG for health care team discharge planning and CDI use.
  • Performs other duties as assigned
Supervisory/Management Responsibilities
  • This is a non-management job that will report to a supervisor, manager, director or executive.
Minimum Requirements
  • Education - Associate degree in Nursing, Health Information Management, or related field of study
  • Experience - Two (2) years -adult medical/surgical/critical care/ER/PACU nursing coding or related experience
In Lieu Of
  • In lieu of the education and experience requirements noted above, the following combination of education, training and/or experience may be considered an equivalent substitution: MD/DO/PA/NP
Required Certifications, Registrations, Licenses
  • RN/RHIA/RHIT/CCS/CIC/or Licensure in related field of study
Knowledge, Skills and Abilities
  • Strong computer skills
  • Strong communication skills with ability to interact with providers.
  • General knowledge of IPPS, ICD10 Coding, MS-DRG/APR-DRG and HCPCS coding systems preferred


Work Shift
Day (United States of America)

Location
Corporate

Facility
7001 Corporate

Department
70017540 Clinical Documentation Integrity

Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

About the Company

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Prisma Health