Specialist-Clinical Documentation III RN Job ID 39190 Job Category: Administrative Non Clinical Support Work Type: Full Time Work Schedule: Days Department: Clinical Documentation Integrity Facility: BMHCC System Services Location: Jackson, MS
Job Summary Evaluates the day to day documentation practices of the Medical Staff and healthcare team on a complex patient population and offers education and recommendations in accordance with the Clinical Documentation Program. Provides clinical expertise in the documentation and coding of diagnoses and procedures, stays abreast of coding and reimbursement changes, promotes quality coding, and serves as a resource to the coding staff. Reports to the Corporate Clinical Documentation Manager. Performs other duties as assigned.
Responsibilities Facilitates appropriate clinical documentation to support appropriate diagnosis coding and to ensure the level of service rendered to all patients is recorded.
• Performs Quality mortality reviews to ensure documentation accuracy and to maximize the severity of illness and risk of mortality. • Performs reviews for risk adjustment model indicators such as CMS quality measures present on admission, pay for performance value-based purchasing, and other national reporting initiatives. • Also works with hospital performance improvement and quality departments on Patient Safety Indicators (PSIs) and Hospital Acquired Condition (HAC) reductions. • Improves documentation specificity and acuity by educating physicians, clinicians, and other involved parties regarding the necessity of providing complete and clear documentation of the care provided throughout a patients stay. • This includes capturing complications and co-morbidities during the patients stay. This is achieved via clarifications, face-to-face communications, and/or other educational programs and tools useful and necessary to achieve this goal.
• Works independently in a hybrid work mode - working both in-facility as well as remotely and has multi-facility entity responsibility. • Serves as a member of the clinical team that supports specific Hospital and System initiatives and aids HIM Department in meeting their time requirement of the coding and billing revenue cycle. • Must demonstrate knowledge of the principles of disease definitions and natural history, possess the ability to assess data reflective of the patients clinical status, interpret the appropriate information needed to identify each patients acuity and severity of illness. • Establishes the working DRG assignments. When applicable, collaborates with coding liaison to determine accurate final DRG assignment. • Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association. • Attends weekly, monthly, and/or yearly departmental meetings and educational offerings as scheduled.
Specifications Experience Minimum Required: 5 years of Clinical experience in an acute care facility. The experience must be pertinent and current to the specialty of the patient population. Preferred: ICD coding experience ICU or ED and/or Case Management experience at multi-facilities.
Education Minimum Required: Associates Degree in Nursing or higher in nursing Preferred: BSN
Training Minimum Required: Knowledge of theories, principles, and concepts acquired through completion of RN program. Strong computer skills required. Interpersonal Communication skills, Organizational skills Preferred: Knowledge of ICD-10 coding, however content training in coding will be provided.
Licensure Minimum Required: Current state RN licensure Preferred: CCDS preferred but not required
Equal Opportunity Baptist is an equal employment opportunity employer and prohibits discrimination based on an individuals race, color, religion, national origin, pregnancy, sex, age, handicap, disability, physical, visual, or mental creed, marital, and veteran status, genetic information, or any other category protected by federal or state law with respect to all aspects of the employment process, including recruitment, selection, placement, promotion, wages, benefits, and other terms and conditions of employment.
Join our Talent Network to receive updates on new and noteworthy happenings at Baptist.
Home Talent Networks Recruitment Events Center for Career Development Privacy Policy Copyright 2021 Baptist Memorial Health Care Corporation. All Rights Reserved.