Clinical Documentation Specialist

4 weeks ago


Lewes, Delaware, United States Bebee Healthcare Full time
Why Beebe Healthcare?

Beebe Healthcare is a vibrant, coastal community-based healthcare organization that values inclusivity and teamwork. As a Clinical Documentation Specialist, you will play a crucial role in supporting our Health systems Value-based care efforts, improving quality care for our patients and community.

Benefits
  • Competitive compensation and wellness benefits (medical, dental, vision, and prescription)
  • Sign-on bonus of $2,500
  • Tuition Assistance up to $5,000
  • Paid Time Off
  • Long Term Sick accrual
  • Employer Contribution Plan
  • Free Short and Long-Term Disability for Full Time employees
  • Zero copay for drugs on prescription plan for certain conditions
  • College Bound 529 Savings Plan
  • Life Insurance
  • Beebe Perks via Work Advantage
  • Employee Assistance Program
  • Pet Insurance
Job Summary

The Clinical Documentation Specialist will provide thorough concurrent, prospective, and retrospective review of ambulatory medical record clinical documentation to ensure accurate and complete capture of the clinical picture, severity of illness, and complexity of the patient. This role will utilize knowledge of official coding guidelines (ICD-10, CPT, HCPCs), Hierarchical Condition Categories (HCC), M.E.A.T (Monitored, Evaluated/Assessed/Addressed, Treated) standards, Risk Adjustment Factor (RAF) scoring, and AHIMA/ACDIS physician query brief.

Responsibilities
  • Review provider documentation of diagnostic data from medical record to verify that all Medicare Advantage, MSSP, and Commercial risk adjustment documentation requirements are met
  • Deliver education to providers on either an individual basis or in a group forum
  • Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC)
  • Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines
  • Interact with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation
  • Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing
  • Provide ongoing feedback to physicians and other providers regarding coding guidelines and requirements, including education and support for improvement in HCC coding and RAF scoring
  • Assist with educational in-services for physicians, other providers, and clinic staff relating to clinical documentation compliance related to billing
Credentials

Required Certification/Licensure:

  • Certified Risk Adjustment Coder (CRC)
  • Certified Coding Specialist (CCS-P)
  • Certified Coding Specialist (CCS)
  • Certified Professional Coder (CPC)

Minimum of two years' experience in medical coding

Reliable transportation/Valid Driver's License/Must be able to travel at least 50% of work time

Entry: USD $22.75/Hr.

Expert: USD $35.26/Hr.



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