Senior Clinical Documentation Specialist

Job Summary

Conducts thorough analysis of inpatient medical records for clinical review and assessment of the documented clinical condition and care provided. Works with coding to ensure the DRG assigned is accurately and completely represented in documentation for system reimbursement. Collaborates with physicians and other health care professionals to address areas of opportunity identified through encounter data or claim denials.

Essential Functions

• Works for the promotion of proper and ethical documentation and coding/billing activities thus improving the organizations level of accurate reimbursement. Conducts in-depth analysis of documentation of clinical care rendered in inpatient settings. Uses critical analysis to determine appropriate DRG or coding assignment appropriate setting medical necessity coverage of experimental services and clinically related visits. Ensures that services are provided in accordance with state and federal regulations organizational policy and accreditation/compliance requirements.
• Prepares detailed clinical summaries and/or other clinical documentation as necessary for role.
• Analyzes current practices in the areas of patient care documentation and coding/billing utilizing observation and data/statistical analysis to identify areas of opportunity.
• Develops and communicates recommended solutions/programs to address problem areas to physicians and other health care professionals. Communicates study or other findings and trains physicians and other healthcare professionals as required in current data and healthcare trends as it relates to appropriate clinical documentation and evidenced-based medicine.
• Utilizing project management skills identifies project scope project requirements decision points timelines and resource requirements for planning prioritization implementation and evaluation of complex multifaceted quality and patient safety decision support projects and programs.
• Aids in the continuous monitoring of data for quality cost effectiveness and efficiency. Engages in process and quality improvement activities.
• Engages in continuous study of the entire professional field including best practices to maintain the professional competence knowledge and skills necessary for the satisfactory performance of all assigned responsibilities. Completes required continuous training and education including department specific requirements.

Qualifications

Required

• Bachelors degree in nursing Health Related Field or Business Administration
• 3 years of relevant inpatient clinical Role experience
• Direct patient care and bedside experience
• LIC-Registered Nurse (RN) - STATEMI State of Michigan Upon Hire Or
• LIC-Nurse Practitioner (NP) - STATEMI State of Michigan Upon Hire Or
• LIC-Physician Assistant - STATEMI State of Michigan Upon Hire

Preferred

• Masters Degree Health Related Field

• Clinical Documentation Review

• CRT-Clinical Documentation Specialist Certified (CCDS) - UNKNOWN Unknown CCAP Department

About Corewell Health

As a team member at Corewell Health you will play an essential role in delivering personalized health care to our patients members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators leaders and innovators that continue to build on one shared mission statement - to improve health instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

How Corewell Health cares for you

• Comprehensive benefits package to meet your financial health and work/life balance goals. Learn more here.

• On-demand pay program powered by Payactiv

• Discounts directory with deals on the things that matter to you like restaurants phone plans spas and more!

• Optional identity theft protection home and auto insurance pet insurance

• Traditional and Roth retirement options with service contribution and match savings

• Eligibility for benefits is determined by employment type and status

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Corewell Health is committed to providing a safe environment for our team members patients visitors and community. We require a drug-free workplace and require team members to comply with the MMR Varicella Tdap and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process to perform the essential functions of a job or to enjoy equal benefits and privileges of employment due to a disability pregnancy or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race color national origin sex disability age religion genetic information marital status height weight gender pregnancy sexual orientation gender identity or expression veteran status or any other legally protected category.

An interconnected collaborative culture where all are encouraged to bring their whole selves to work is vital to the health of our organization. As a health system we advocate for equity as we care for our patients our communities and each other. From workshops that develop cultural intelligence to our inclusion resource groups for people to find community and empowerment at work we are dedicated to ongoing resources that advance our values of diversity equity and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.