Job Summary

Analyze medical records for inpatient and outpatient service areas for accuracy of coding and documentation to ensure regulatory compliance.

Job Duties and Responsibilities

• Analyze medical records for inpatient and outpatient service areas for accuracy of coding and documentation to ensure regulatory compliance.
• Apply knowledge of medical terminology, disease conditions and procedures to evaluate clinical documents.
• Monitor diagnoses, treatments, and follow-up entries in medical records to lead to coding accuracy.
• Identify gaps in clinical documentation and request missing information from the appropriate providers.
• Develop and implement plans for both formal and informal education of physicians, CDI team, health information management and other clinical staff.
• Develop in-service education tools as necessary for physicians, CDI team and ancillary staff and assist physician champion to conduct education as needed.
• Train CDI team, physicians and other medical staff on suitable documentation processes to ensure consistency and accuracy of clinical documentation.
• Interpret and prepare clinical reports for healthcare professionals, executives and other stakeholders to discuss documentation trends, outcomes and go forward plans.
• Meet with healthcare stakeholders to explain findings and facilitate actions based on recommendations.
• Participate in and facilitate executive meetings to explain CDI benchmarks, KPIs and demonstrate overall program accomplishments and challenges through analytics and dashboards.
• Conducts and monitors the provider education to ensure appropriate and timely usage of face-to-face meetings, conference calls, Web Conferencing and group facility meetings.
• Create and deliver presentations at local and national conferences and/or client meetings.
• Keep up to date with advancements changes in regulations pertaining to coding, clinical documentation and health information technology.

Required Qualifications

• Bachelor’s degree in nursing, medical degree, or physician assistant required.
• Current Registered Nurse (RN) license required.
• Certified Clinical Documentation Specialist – CCDS (inpatient) certification required.
• A minimum of 3 years of experience in acute inpatient settings.
• Extensive experience in collecting, interpreting and communicating medical information to select appropriate clients with recommendations and plan of action.
• Knowledge of care delivery documentation systems and related medical record documents.
• Knowledge of age-specific needs and the elements of disease processes and related procedures.
• Strong broad-based clinical knowledge and understanding of pathology/physiology of disease processes.
• Strong analytical skills.
• Ability to keep up to date with advancements and regulations in medical coding and clinical documentation.
• Proficient in MS Word, Excel and PowerPoint preferred.
• Proficient in Electronic Medical Record (EMR) software, such as Epic, Cerner, Allscripts, etc. required.
• Excellent verbal and written communication skills with small and large group presentation skills.
• Ability to work independently and with multiple teams in a time-sensitive environment.
• Ability to travel 50-70%, on average , based on the work you do and the clients and industries/sectors you serve.
• Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future.

Preferred Qualifications

• Master’s degree in Clinical Informatics, Business Administration, Nursing and related health fields preferred.
• Case Management or Medical coding certification a plus (CRC, CCA, CCS-P, CCS, CPC, CDIP, CCM).
• Experience as clinical registered nurse, physician, physician assistant, case manager, clinical documentation specialist, utilization review, informatics RN, Quality, DRG Validation and health IT preferred.
• Knowledge of Medicare reimbursement system and coding structures preferred.
• In-depth knowledge and experience in medical terminology, medical coding, and ICD-10-CM/PCS, IPPS payment system is a plus.
• Experience in quality measurement, quality improvement, and value-based payment models.
• Proven applicable CPT and ICD-10 coding experience; APR-DRG, MS-DRG and HCC assignment.
• Other revenue cycle experience including conducting charge capture and coding reviews for compliance with billing and coding regulatory requirements.
• Experience in program and/or project management for technology implementations using third party software.
• Knowledge of process excellence (Six Sigma, LEAN, Design Excellence), certifications preferred.
• Experience training, educating and coaching.

Application Instructions

• All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or protected veteran status, or any other legally protected basis, in accordance with applicable law.
• Qualified applicants with criminal histories, including arrest or conviction records, will be considered for employment in accordance with the requirements of applicable state and local laws, including the Los Angeles County Fair Chance Ordinance for Employers, City of Los Angeles’s Fair Chance Initiative for Hiring Ordinance, San Francisco Fair Chance Initiative for Hiring Ordinance, and the California Fair Chance Act.

Wage Range

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $88600 to $163100

Benefits

Deloitte is committed to providing reasonable accommodations for people with disabilities. If you require a reasonable accommodation to participate in the recruiting process, please direct your inquiries to the Global Call Center (GCC) at [email protected].

Deloitte is committed to providing reasonable accommodations for people with disabilities. If you require a reasonable accommodation to participate in the recruiting process, please direct your inquiries to the Global Call Center (GCC) at [email protected].

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