Share Email Opening Title Clinical Documentation Improvement Specialist (569)  Category Health Information Services - 7180   Description JOB SUMMARY: Reviews concurrent and/or discharged physician documentation to assure completeness, accuracy and consistency to improve overall quality of clinical documentation, to ensure the patients' severity of illness is accurately portrayed in the medical record for specificity of coding and increased coding accuracy and to ensure the most appropriate reimbursement is achieved for the level of service rendered to all inpatients. Provides continuous education to both the Medical Staff and Coding Staff. Communicates with clinical staff when documentation needs further specificity. Initiates queries as necessary based on evaluation of clinical information. Ensures the accuracy and completeness of clinical information used for measuring and reporting physician and hospital pay for performance diagnosis specific quality outcomes. Uses assertive interpersonal skills to discuss clinical documentation issues and work effectively with all levels of internal and external customers. Articulates the program to physicians and other health care professionals in order to educate and teach clinical documentation requirements for DRG reimbursement, pay for performance quality outcome measures, CMI, ROM and SOI. Encourages a spirit of cooperation among clinicians. Assists in clinical validation reviews related to the denials and appeals processes. Attends and actively participates in Clinical Documentation Improvement meetings with physicians, and other applicable meetings. Contributes to a positive working environment and performs other duties as assigned. QUALIFICATIONS: JOB SPECIFIC CORE COMPETENCIES: Aptitude for detail and accuracy. Ability to work unsupervised. Ability to prioritize. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Reviews the medical record for specificity of documentation prior to the account being coded. Assists in retrieval of data for selected studies requested by Quality. Keeps current on coding guidelines, rules and regulations, and new codes. Keeps current on Clinical Documentation Integrity/Improvement standards and guidelines. Generates reports as requested. Demonstrates ability to embrace and adapt to change. Regularly initiates ideas to improve the efficiency and processes of the department in a positive and productive manner by attending at least 90 percent of monthly departmental meetings. Keeps current on coding guidelines, rules and regulations, and new codes. Provides continuous education to Medical and Coding Staff. Seeks assistance only after referring to own resources. Other duties as assigned. EXPECTED BEHAVIORS Productivity Level: Initial Reviews: 8 per day or 40 per week. Subsequent/retrospective reviews: 12 per day or 60 per week. Total: At least 20 per day or 100 per week.   Position Requirements LICENSURE/CREDENTIAL REQUIREMENTS: Bachelor of Science in Nursing preferred. A degree in Health Information Management with credentials of RHIA, RHIT, CDIP, CCDS, or CCS with extensive clinical knowledge and a minimum of 3 years inpatient hospital acute care experience will be considered in lieu of an RN. If hired as RHIA or RHIT without CCS, CDIP or CCDS, CDIP or CCDS will be expected within 24 months of hire. ADDITIONAL EDUCATION AND EXPERIENCE REQUIREMENTS: Certified Clinical Documentation Improvement/Integrity Specialist (CDIP or CCDS) required. If hired without CDIP or CCDS certification, must obtain within first 24 months of hire. Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) accepted. If hired without CDIP or CCDS certification, must obtain within first 24 months of hire Working knowledge of the ICD-10-CM and PCS coding systems, medical terminology, anatomy and physiology. Experience in computer operations. Types accurately at least 30 WPM. Mandatory Continuing Education: Customer Service, Fire and Safety, Corporate Compliance (including Confidentiality), Infection Control, and education required by regulatory, accreditation bodies, scope of practice, and/or Hancock Regional Hospital.   Full-Time/Part-Time Full-Time   Shift -not applicable-   Resubmittal due to closure after 120 days open?   Number of Openings   Exempt/Non-Exempt   Position Clinical Documentation Improvement Specialist (569)   Number of Openings 1   Exempt/Non-Exempt Non-Exempt   Open Date 10/24/2023   Location Hancock Regional Hospital   About the Organization YOUR HEALTH IS OUR LIFE Hancock Health is an Indiana-based, full-service healthcare network serving Hancock County and the surrounding areas. Our health system includes Hancock Regional Hospital, Hancock Physician Network and more than 20 other healthcare facilities, such as wellness centers, women's clinics, family practices, and the Sue Ann Wortman Cancer Center. A Caring Community Partner Our goal at Hancock Health is simple: To give every person the personalized attention necessary for a happy, healthy life. Our mission, vision, and values embody this goal. OUR MISSION To be a Caring Community Partner by healing, improving health and wellness, alleviating suffering, and delivering acts of kindness one person at a time. OUR VISION To be nationally recognized for kindness in the delivery of excellent quality patient care, efficient and effective operations, the adoption of proven technologies, the creation of a positive workplace environment, and excellence in community service. OUR VALUES Exceptional | Honorable | Devoted | Reliable | Kind   EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.   This position is currently not accepting applications. To search for an open position, please go to http://HancockRegionalHospital.appone.com WE ALSO RECOMMEND Other Jobs Within Same Category -- None found -- Other Jobs Within 60 Miles -- None found --

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