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Senior Outpatient Clinical Documentation Integrity Specialist - HYBRID at Vanderbilt University Medical Center

Senior Outpatient Clinical Documentation Integrity Specialist - HYBRID

Vanderbilt University Medical Center Jefferson City, MO (On Site) Full-Time
Senior Outpatient Clinical Documentation Integrity Specialist - HYBRID - 2214791

**Job** : Medical Coding and Billing

**Primary Location** : Work from Home

**Organization** : Coding-Medicine/OBGYN/Neuro 108488

**Shift:** : First Shift

**Description**

**Senior Outpatient Clinical Documentation Integrity Specialist - HYBRID**

**JOB SUMMARY**

We are currently recruiting an Senior Outpatient Clinical Documentation Integrity Specialist to support clinical documentation integrity and coding within practices participating in value-based contracts. This position is critical to our practices' ability to provide better care to Medicare beneficiaries. The Senior Outpatient Clinical Documentation Integrity Specialist is expected to be an exemplar of regulatory compliance. The Senior Outpatient Clinical Documentation Integrity Specialist will lead field and provider education and training related to complete and accurate diagnostic documentation and coding, in accordance with ICD-10 CM coding guidelines, internal protocols and CMS and payer guidelines. The Senior Outpatient Clinical Documentation Integrity Specialist will develop and deliver tailored education at the national, market, practice, and individual provider-level; complete end-to-end workflow assessment and optimization; and perform chart reviews to identify specific opportunities for improved accuracy. Work from home with requirement to travel periodically to practices in Nashville, TN area.

**KEY RESPONSIBILITIES**

+ Develop and implement action plans to improve the completeness and accuracy of clinical documentation and diagnosis coding

+ Create and deliver internal and external-facing education and training on clinical documentation and diagnosis coding

+ Collaborate with leaders on clinical documentation and coding best practices

+ Evaluate and optimize end-to-end practice clinical documentation and coding workflows

+ Perform chart reviews to identify opportunities for better accuracy in clinical documentation and coding

+ Partner with internal stakeholders to improve reporting and analytics tools to drive improvements in the accuracy and completeness of clinical documentation and diagnosis coding

+ Work directly with assigned practices and providers on continuous improvement of complete and accurate documentation and diagnosis coding

+ Facilitate clinical documentation and coding communication amongst key internal and external stakeholders

+ Provide guidance to field staff and practices regarding general documentation and coding best practices

+ Support performance in value-based contracts

**TECHNICAL CAPABILITIES**

MEDICAL CODING (ADVANCED):

- The transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes.

MEDICAL TERMINOLOGY & DOCUMENTATION (ADVANCED):

- The ability to comprehend medical terminology and documentation in an office, or surgical setting.

CRITICAL THINKING (ADVANCED):

- The objective analysis and evaluation of an issue in order to form a judgment.

COMPLIANCE (ADVANCED):

- Understanding the rules, regulations, sanctions and other statutory requirements, guidelines and instructions relating to governing bodies and organizations, both internally and externally.

**CORE ACCOUNTABILITIES**

Organizational Impact: Independently delivers on objectives with understanding of how they impact the results of own area/team and other related teams.

Problem Solving/ Complexity of work: Utilizes multiple sources of data to analyze and resolve complex problems; may take a new perspective on existing solution.

Breadth of Knowledge: Has advanced knowledge within a professional area and basic knowledge across related areas.

Team Interaction: Acts as a "go-to" resource for colleagues with less experience; may lead small project teams.

**BASIC QUALIFICATIONS**

+ Bachelor's degree in a healthcare related field or equivalent work experience required

+ Current certification as a Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC) from AAPC required

+ Preferred certification as a Certified Documentation Expert Outpatient (CDEO®) from AAPC or Certified Clinical Documentation Specialist-Outpatient (CCDS-O) from ACDIS.

+ 3 years of recent, relevant work experience as a risk adjustment coder

+ Thorough understanding of medical coding guidelines and regulations including compliance and the impact of diagnosis documentation on risk adjustment payment models

+ Subject matter expertise on the CMS HCC Risk Adjustment program, methodology, and impact to value-based contracts

+ Ability to identify and communicate opportunities to improve documentation and diagnosis capture for accurate risk adjustment coding

+ Experience working directly with physician practices and individual providers to achieve demonstrable improvement in increasing the accuracy and completeness of documentation and diagnosis coding

+ Excellent verbal and written communication skills

**Basic Qualifications**

Bachelor's Degree (or equivalent experience) in a healthcare related field or equivalent work experience required Current certification as a Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC) from AAPC required and 3 years relevant experience

**Licensure, Certification, and/or Registration (LCR):**

+ **Additional Qualification Information:**

+

* Preferred certification as a Certified Documentation Expert Outpatient (CDEO®) from AAPC or Certified Clinical Documentation Specialist-Outpatient (CCDS-O) from ACDIS.

* 3 years of recent, relevant work experience as a risk adjustment coder

* Thorough understanding of medical coding guidelines and regulations including compliance and the impact of diagnosis documentation on risk adjustment payment models

* Subject matter expertise on the CMS HCC Risk Adjustment program, methodology, and impact to value-based contracts

* Ability to identify and communicate opportunities to improve documentation and diagnosis capture for accurate risk adjustment coding

* Experience working directly with physician practices and individual providers to achieve demonstrable improvement in increasing the accuracy and completeness of documentation and diagnosis coding

* Excellent verbal and written communication skills **Physical Requirements/Strengths needed & Physical Demands:**

+ Sedentary category requiring exertion up to 10 lbs. of force occasionally and uses negligible amounts of force to move objects. Sedentary work involves sitting most of the time. **Movement**

+ Occasional: Standing: Remaining on one's feet without moving.

+ Occasional: Walking: Moving about on foot.

+ Occasional: Lifting under 35 lbs: Raising and lowering objects under 35 lbs from one level to another

+ Occasional: Carrying under 35 lbs: Transporting an object holding in hands, arms or shoulders, with help of coworkers or assistive device.

+ Occasional: Push/Pull: Exerting force to move objects away from or toward.

+ Occasional: Bending/Stooping: Trunk bending downward and forward by bending spine at waist requiring full use of lower extremities and back muscles

+ Occasional: Reaching above shoulders: Extending arms in any direction above shoulders.

+ Occasional: Reaching below shoulders: Extending arms in any direction below shoulders.

+ Occasional: Handling: Seizing, holding, grasping, turning or otherwise working with hand or hands.

+ Occasional: Bimanual Dexterity: Requiring the use of both hands.

+ Occasional: Standing: Remaining on one's feet without moving.

+ Occasional: Walking: Moving about on foot.

+ Occasional: Lifting under 35 lbs: Raising and lowering objects under 35 lbs from one level to another

+ Occasional: Carrying under 35 lbs: Transporting an object holding in hands, arms or shoulders, with help of coworkers or assistive device.

+ Occasional: Push/Pull: Exerting force to move objects away from or toward.

+ Occasional: Bending/Stooping: Trunk bending downward and forward by bending spine at waist requiring full use of lower extremities and back muscles

+ Occasional: Reaching above shoulders: Extending arms in any direction above shoulders.

+ Occasional: Reaching below shoulders: Extending arms in any direction below shoulders.

+ Occasional: Handling: Seizing, holding, grasping, turning or otherwise working with hand or hands.

+ Frequent: Sitting: Remaining in seated position

+ Frequent: Fingering: Picking, pinching, gripping, working primarily with fingers requiring fine manipulation.

+ Frequent: Sitting: Remaining in seated position

+ Frequent: Fingering: Picking, pinching, gripping, working primarily with fingers requiring fine manipulation. **Sensory**

+ Continuous: Communication: Expressing or exchanging written/verbal/electronic information.

+ Continuous: Auditory: Perceiving the variances of sounds, tones and pitches and able to focus on single source of auditory information

+ Continuous: Vision: Clarity of near vision at 20 inches or less and far vision at 20 feet or more with depth perception, peripheral vision, color vision.

+ Continuous: Communication: Expressing or exchanging written/verbal/electronic information.

+ Continuous: Auditory: Perceiving the variances of sounds, tones and pitches and able to focus on single source of auditory information

+ Continuous: Vision: Clarity of near vision at 20 inches or less and far vision at 20 feet or more with depth perception, peripheral vision, color vision. **Environmental Conditions**

**Req ID:** 2214791

Vanderbilt University Medical Center is committed to principles of equal opportunity and affirmative action.

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