Clinical Documentation Integrity Specialist

Emploi pas sur LinkedIn

🕒 il y a 11 jours

🏄 California – Distant

🏄 California – Remote

💵 $100 161 - $218 718 / an

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

🏥📝 Rédacteur Médical

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UCLA Health

Site WebLinkedInTous les Emplois

10 000+ employés

Fondée en 1955

🏥 Santé

📚 Éducation

🔬 Science

Healthcare • Education • Science

UCLA Health est un système de santé académique intégré soutenu par l'École de Médecine de l'UCLA qui fournit des soins aux patients, une éducation médicale et une recherche clinique dans tout le sud de la Californie. Avec plus de 290 sites, incluant des hôpitaux, des cliniques spécialisées et des centres de soins immédiats/primaires, UCLA Health offre une large gamme de services—soins contre le cancer, transplantation, neurosciences, orthopédie, cœur et vaisseaux sanguins, pédiatrie, santé des femmes, psychiatrie et plus encore—tout en proposant des soins virtuels, des essais cliniques et des ressources pour les patients comme myUCLAhealth. L'organisation met l'accent sur une technologie avancée, des traitements basés sur la recherche, l'engagement communautaire et des résultats exceptionnels en matière de soins hospitaliers classés au sommet.

Description

• Make a positive impact on one of the nation’s top health systems • Help ensure the efficient delivery of award-winning patient care • Take your professional expertise to the next level • Become a member of a highly successful Clinical Documentation Integrity and Denial Management team • Involve daily review of high-acuity patient records to identify potential and active payer denials • Assess clinical validity • Support denial prevention, analysis, and appeals across inpatient and outpatient settings • Continuously communicate with department staff • Educate physicians, residents, and mid-levels • Assist with appropriate documentation strategies • Partner with Medical Coding, Clinical Documentation Integrity, Case Management, and Quality team • Gather/analyze information to provide comprehensive medical record documentation • Ensure accuracy and completeness of clinical documentation for denial prevention • Prepare and submit high quality appeal letters supported by clinical evidence, regulatory guidelines, and payor-specific medical necessity criteria • Identify denial trends and root causes and provide feedback to the CDI and Clinical teams

🎯 Exigences

• Bachelor’s degree in health-related field, preferred • A Registered Nurse (RN) license or MD diploma (or equivalent) required • Three or more years of Clinical Documentation Integrity experience required, preferably at an AMC • Knowledge of coding guidelines and coding clinic, required • Knowledge of laws, rules and regulations regarding appropriate clinical documentation for Medicare, Medi-Cal, CCS etc. • Strong leadership, supervisory, and training skills • Excellent critical thinking abilities • Experience working within EPIC and 3M 360 Encompass CAC, required • Resourcefulness and strong communication, organizational, and analytical skills • Ability to work effectively with physician/staff and interdisciplinary teams • Computer proficiency and proficiency in Word, Excel and PowerPoint, required • Skill in abstracting/interpreting medical information from patient records, required • Clinical experience sufficient to understand and communicate medical diagnoses and courses of treatment to professional and non-professional personnel, required • Knowledge of computer word processing, database programs, and ability to write reports and do graphical analysis, required