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The Compliant Documentation Management program reviews medical record documentation to ensure the overall completeness, compliance, and specificity of the Provider documentation. Such activities help facilitate accuracy and compliance with numerous revenue integrity components: proper coding and DRG assignments; CMI; reimbursement; appropriate LOS assignations; clarification of the POA/HAC status; quality of care core measures and PSI; support for specific hospital and system initiatives; aids HIMs dept. in meeting their time requirements of coding and billing revenue cycle; and assists with denials/audit prevention.
Bring your 2-3 years of acute or clinical experience to our team and enjoy a very flexible work enviorment while working with a very cohesive team. You have an opportunity to work from home once training is completed. We have a few opportunties availble includng Banner University Medical Center ( McDowell/10thSt), Banner Thunderbird and Banner Baywood.
Your pay and benefits (Total Rewards) are important components of your Journey at Banner Health. Banner Health offers a variety of benefit plans to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life.
About Banner Health Corporate
Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.
About Banner Health
Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better.
The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.
This position is responsible for reviewing content of the medical record and assisting in the clarification of any documentation ambiguities noted. This position is a member of the clinical team and acts as a consultant/subject matter expert to facility staff/providers related to medical record clinical documentation requirement to ensure the overall completeness, compliance and specificity of physician documentation exists. This position is responsible for identifying and capturing additional revenue opportunities and will also be the documentation liaison for the facility between coding and physicians.
Provides subject matter expertise related to DRG, clinical documentation opportunities and requirements. Serves as an essential member of the clinical team, emphasizing their role in reviewing content of the medical record, assisting in the clarification of documentation ambiguities. Serves as the liaison between coding and physicians to explain, educate and assist in the needed documentation requirements to accurate conversion from the clinical language to the needed coding language in order to capture revenue.
Conducts accurate and timely concurrent record reviews, recognizing opportunities for documentation improvement through specialized training and software. Utilizes available resources to formulate clinically credible documentation clarification questions for members of the clinical team aimed at improving the accuracy of the documentation process which is followed by effective and appropriate communication with physicians and timely follow up on all cases.
Ensures data integrity of the clinical documentation database through compliant, accurate and appropriate entries, which include but is not limited to, accurate input of case data, correct assignment of documentation clarification types and provider responses, and ensuring precise case reconciliation with correct DRG shifts recorded.
Ensures the accuracy and completeness of clinical information used for measuring and reporting physician and facility outcomes (coding assignments, HAC, quality of care, facility and system initiatives) while facilitating HIMS dept compliance of time requirements for coding and billing revenue cycle.
Educates customers and creates presentations and/or reports for clinicians and facility management on clinical documentation opportunities, coding and reimbursement issues, as well as performance improvement methodologies.
Serves as member of facility task force meetings, and as requested attends facility steering committee meetings and/or other facility meetings.
Must possess a strong knowledge of clinical care as normally obtained through the completion of a bachelors degree in nursing, healthcare or related field.
Requires RN licensure in the state of practice or equivalent clinical knowledge. RNs must possess licensure. Exceptions: Verification of graduation from a foreign medical school (Doctor of Medicine degree).
Requires a proficiency level typically attained with 2-4 years acute-care, inpatient hospital, clinical experience. Must have the ability to work independently, possess demonstrated critical thinking skills, problem-solving abilities, effective communication skills and time management skills. Must demonstrate ability to work effectively in an interdisciplinary team format.
Must pass a written clinical competency examination with minimum score of 70.
Experience with clinical documentation programs, use of electronic health record and coding preferred.
Additional related education and/or experience preferred.