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Clinical Documentation Specialist

ChenMed Miami, FL

  • Expired: over a month ago. Applications are no longer accepted.
Job Description

ChenMed is transforming healthcare for seniors. We provide big answers to big problems in health care delivery. ChenMed is a full-risk primary care market leader with an innovative philosophy, unique physician culture and end-to-end customized technology. These things allow us to provide world-class primary care and coordinated care to the most vulnerable population – moderate- to low-income seniors who have complex chronic diseases.

Through our innovative operating model, physician-led culture and empowering technology, we are able to drive key quality and cost outcomes that create value for patients, physicians and the overall health system. Our model allows us to practice medicine the way it should be practiced. By recruiting focused physicians and reducing their doctor-to-patient ratios, we increase patients’ “face time” during each monthly appointment and help foster stronger doctor-patient relationships. Our model also drives and enhances compliance with treatment plans.

As a result of our efforts, our patients realize lower hospital admissions. Their overwhelming response to our approach is reflected in our aggressive, organic growth and net promoter scores in the low to mid 90s, which is unheard of in any industry. Read more about our results and the value of the ChenMed model.

As a company, we are making a difference in the lives of seniors and the health care system overall.

ESSENTIAL JOB DUTIES/RESPONSIBILITIES:
  • Represents proper risk adjustment processes, analyzes trends and data to assist with Hierarchal Condition Categories (HCC) accuracy to providers and other clinical staff.
  • Helps HRDD (High Risk Disease Detection) managers by verifying reports, extracting data and researching information to provide to PCPs.
  • Reviews hospital and past medical records with the purpose of recommending missed diagnoses to the PCP.
  • Prepares information and analyses for use by High Risk Disease Detection managers in their presentations to physicians, clinical personnel and corporate leadership.
  • Reviews charts for accuracy, quality and completeness of clinical records. Reviews patient medical records to judge appropriate diagnosis, assessments and plans and overall TAMPER (Treatment, Assessment, Monitor, Plan, Evaluate, Referral).
  • Facilitates improvement in overall quality, completeness, and accuracy of medical record documentation. Obtains appropriate clinical documentation through interaction with clinic staff to ensure that documentation reflects the level of service rendered to patients.
  • Identifies, compiles and codes patient data, using ICD-10CM and other standard classification coding systems.
  • Works closely with clinical and HRDD leadership to make sure coding standards are met and there is maximization of appropriate and accurate coding, as well as prevention of inappropriate coding.
  • Releases information to requesting persons and agencies according to regulations. Protects the security of medical records to ensure that confidentiality is maintained.
  • Attends meetings with HRDD and coding departments as necessary to review records and new procedures and to keep abreast of CMS updates.
  • Assists in the creation of educational materials for coders, HRDD managers and clinical personnel.
  • Provides support to HRDD managers in different markets as required to improve accuracy in each market’s Medicare Risk Adjustment.
  • Performs other duties as assigned and modified at manager’s discretion.

At ChenMed, If you are an innovative, entrepreneurial minded, over-achiever who is extremely passionate in helping people and revolutionizing Healthcare again, we are that dynamic and exciting company you are looking for!

After applying, we encourage you to "follow" us on LinkedIn (ChenMed) as well! This way you can stay informed and up to date on what’s happening around our organization and start your path to becoming part of our FAMILY!

KNOWLEDGE, SKILLS AND ABILITIES:
  • In depth understanding of Medicare Risk Adjustment, compliance and requirements, and coding guidelines
  • Understanding of clinical disease definitions and guidelines for identification
  • Strong communication skills and ability to converse and collaborate with clinicians and other company leadership
  • Should possess the analytical skills necessary to identify trends, inconsistencies and inaccuracies
  • Proficient in Microsoft Office Suite products including Excel, Word, PowerPoint and Outlook, plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software
  • Ability and willingness to travel locally, regionally and nationwide up to 25% of the time
  • Excellent communication skills with spoken and written fluency in English
EDUCATION AND EXPERIENCE CRITERIA:
  • Associate Degree preferred
  • Minimum three (3) years in coding, Medicare Advantage and experience in communication with medical providers may substitute for formal education
  • Certified Professional Coder and/or Certified Risk Coder (AAPC or AHIMA) preferred
The High Risk Disease Detection (HRDD) Specialist is responsible for compiling, abstracting and maintaining medical records to document patient condition and treatment. Ensures that all patient documents and records are maintained in accordance with legal, Centers for Medicare and Medicaid Services (CMS) and confidentiality guidelines.

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ChenMed

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Address

Miami, FL
USA

Industry

Healthcare

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