Outpatient Clinical Documentation Specialist

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Boston Medical Center (BMC)

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5001 - 10000 employés

Fondée en 1996

Le Boston Medical Center (BMC) est un centre médical académique de 511 lits, dirigé par l'équité, et un fier membre du Boston Medical Center Health System. Le BMC propose un modèle de soins de santé où des soins innovants et équitables permettent à tous les patients de prospérer. En tant que centre médical académique de premier plan à Boston, un leader national dans les soins cliniques et le plus grand hôpital essentiel de la Nouvelle-Angleterre, les cliniciens de classe mondiale du BMC fournissent des soins complets dans plus de 70 spécialités et sous-spécialités.

Description

• Provide clinically based prospective, concurrent, and retrospective reviews of medical records for WellSense of members enrolled in value-based agreements • Review risk adjustment gap lists for members, including suspect conditions • Perform chart reviews to determine clinical validity of open gaps • Utilize Physician documentation queries to communicate clinical indicators to Physicians/Other Qualified Health Care Providers • Facilitate appropriate physician documentation of care delivery to accurately reflect patient severity of illness and risk of mortality • Track and Trend CDI findings and provider engagement for clinical documentation education purposes for any specialty within the hospital system

🎯 Exigences

• Bachelor’s degree in Nursing or Health Information Management is required • Minimum 5 years related experience working on the payer or provider side in Risk Adjustment Validation including prospective documentation reviews and pre-visit planning • Certified Risk Adjustment Coder required • Population Health experience, NCQA/HEDIS CDS experience preferred • Knowledge of care delivery documentation systems and related medical record documents • Excellent understanding of ICD10CM coding and guidelines • Ability to work independently in a time-oriented environment • Strong broad-based clinical knowledge and understanding of pathology/physiology of disease processes

🏖️ Avantages

• Health insurance • Discretionary annual bonuses • Merit increases • Flexible Spending Accounts • 403(b) savings matches • Paid time off • Career advancement opportunities • Resources to support employee and family well-being