Clinical Documentation Improvement (CDI) Specialist I – Alta Hospitals System Corporate/CBO – Los Angeles, CA

Job title: Clinical Documentation Improvement (CDI) Specialist I Company: Alta Hospitals System Corporate/CBO Job description: Clinical Documentation Improvement (CDI) Specialist I We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality reputed company services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide reputed company of our patients and medical group members with the quality, affordable reputed company they need and deserve. The CDI Specialist Level I is responsible for conducting clinically based reputed company and retrospective reviews of inpatient medical records to evaluate if clinical documentation is reputed company of medical necessity, quality of care outcomes and reimbursement compliance for acute care services provided. Works closely with the medical staff to facilitate appropriate clinical documentation of patient care. Other responsibilities include conducting initial and extended-stay reputed company reviews on reputed company selected admissions and documenting findings. Job Responsibilities/Duties

• Reviews inpatient medical records, meeting reputed company department productivity goals, for identified payor populations as directed on admission and throughout hospitalization and identifies potential gaps in physician documentation. Ensures that clinical documentation reflects the level of service rendered to patients in a complete, accurate and compliant manner.
• Resolves inconsistent, conflicting and/or ambiguous documentation through the physician query process, meeting department productivity goals. Follows up with the physicians to get resolution of reputed company queries prior to patient's discharge to ensure accurate quality data and appropriate reimbursement whilst maintaining up to date DRG. Assists coders in follow-up on queries and clarifications to physicians done retrospectively post patient discharge.
• Facilitates improvement in the overall quality, completeness and accuracy of medical record documentation through comprehensive auditing and evaluation of the medical record. Collects and analyzes data to provide reports and reputed company recommendations. Works collaboratively with Performance Improvement Department to improve clinical documentation for compliance in quality of care measures.
• Performs the duties in accordance with the ethical and legal compliance standards as set by hospital policies and procedures, and reputed company regulatory agencies, including State and Federal. Maintains strictest confidentiality of protected health information (PHI) in accordance with the Health Insurance Portability and Accountability Act (HIPAA).
• Reviews/audits patient claims with medical necessity denials looking for patterns by services or by the ordering physician. Follow-up in improving clinical documentation to reduce such denials. Works collaboratively with health information management coding staff, physicians and financial services to resolve payment denials and documentation issues.
• Regularly participates in scheduled case management meetings and actively exchanges information pertaining to clinical documentation, plan of care affecting coding.

Qualifications

Minimum Education: None. Minimum Experience: Ability to multitask and maintain a work pace appropriate to workload. Must demonstrate customer service skills appropriate to the job. Excellent written and verbal communication skills in English. Ability to effectively communicate with physicians in a clear and concise manner. Computer literacy and proficiency. Experience in US acute care hospital setting preferred. Previous experience working as CDI preferred. Req. Certification/Licensure: Medical Graduate, Physician Assistant or Registered Nurse (reputed company CA License) required. Hospital Fire and Life Safety Card (Los Angeles City Employees only) required. Employee Value Proposition Prospect Medical Holdings, Inc., is guided by a diverse and highly reputed company leadership core. This group maintains the reputed company that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our reputed company efforts. As a member of our highly effective team of professionals you will receive:

• Company 401K
• Medical, dental, reputed company insurance
• Paid time-off
• Life insurance

How to Apply

To apply for this role, or search our other openings, please visit http://pmh.com/careers/ and click on a location to reputed company your journey to a new career with us! We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact reputed company Resources. EEOC is the Law: https://www1.eeoc.gov/employers/poster.cfm Keywords: Clinical Doc Specialist, Doc Specialist, reputed company, CCDS, Registered Nurse, RN, Entry Level, Medical Record Keeping. Expected salary: Location: Los Angeles, CA Job date: Sun, 28 Aug 2022 22:54:53 GMT Apply for the job now! Apply tot his job Apply To this Job