RN Specialist, Clinical Documentation - MUST Reside in Colorado at Denver Health

Denver, Colorado, United States -

Full Time

Start Date

Immediate

Expiry Date

27 Jun, 26

Salary

119800.0

Posted On

29 Mar, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Clinical Documentation Integrity, Concurrent Review, Retrospective Review, Provider Education, Physician Query, ICD-10, Clinical Medicine, CMS Guidelines, Coding Guidelines, Health Information Management, Patient Safety, Quality Assurance, Compliance, DRG Assignments, IPPS, Microsoft Excel

Industry

Hospitals and Health Care

Description

We are recruiting for a motivated RN Specialist, Clinical Documentation - MUST Reside in Colorado to join our team! We are here for life’s journey. Where is your life journey taking you? Being the heartbeat of Denver means our heart reflects something bigger than ourselves, something that connects us all: Humanity in action, Triumph in hardship, Transformation in health. Department REVENUE INTEGRITY Job Summary Under general supervision performs concurrent and retrospective reviews as requested by the Clinical Documentation Integrity Manager or Director. Responsible for selected assignments based on internal or external department requests. Responsible for educating providers regarding documentation specificity, accuracy, compliance and are permitted to query physicians as deemed necessary. Collaborates with Coding, Health Information Management (HIM), Patient Safety and Quality, Enterprise Compliance Services and other departments to promote the common goal of obtaining accurate documentation in the patient's record. Must participate in continuous education on ICD-10, clinical medicine, Center of Medicare and Medicaid (CMS) and other billing carriers, as well as coding guidelines and policies. Essential Functions: Concurrent and/or retrospective review of designated inpatient, outpatient, and ambulatory patient records to assess for accuracy, specificity, and compliance of provider documentation. (20%) Tracking audits performed and audit results obtained in order to provide meaningful data to key stakeholders. (20%) Educating providers regarding documentation accuracy, specificity, and compliance with rules and regulations. (20%) Providing pertinent feedback to providers on audit results as necessary. (20%) Working collaboratively with Coding, Health Information Management (HIM), Patient Safety and Quality, Enterprise Compliance Services, and other departments to promote the common goal of obtaining accurate documentation in the patient record. (20%) Education: Associate's Degree Required Work Experience: 4-6 years Six years of experience as a nurse in a hospital environment Required and 4-6 years Three of the six years with the appropriate level of experience in one or a combination of the following medical documentation related function: clinical coding, case management, DRG coordination, physician education, Medicaid/Medicare reimbursement. Required Licenses: RN-Registered Nurse - DORA - Department of Regulatory Agencies Required Knowledge, Skills and Abilities: Must be able to demonstrate knowledge of the pathophysiology of the disease process. Must be able to demonstrate clinical expertise in areas of urgent/emergent, medical/surgical, obstetrical, pediatric, and ambulatory care. Must be able to communicate and interact tactfully with physicians and other professionals by expressing ideas clearly and concisely and addressing audiences effectively. Ability to read and interpret professional journals, financial reports, and legal documents as necessary. Ability to define problems collects and summarizes data, establish facts and draw conclusions. Possesses knowledge of clinical documentation and coding concepts, DRG assignments, Inpatient Prospective Payment System (IPPS) and CMS rules and regulations. Must also be able to demonstrate knowledge including but not limited to, value-based purchasing, bundled payments, accountable care organizations and readmission reduction program. Microsoft Office Excel and SharePoint Variety of documentation and coding programs. Shift Work Type Regular Salary $77,300.00 - $119,800.00 / yr Benefits Outstanding benefits including up to 27 paid days off per year, immediate retirement plan employer contribution up to 9.5%, and generous medical plans Free RTD EcoPass (public transportation) On-site employee fitness center and wellness classes Childcare discount programs & exclusive perks on large brands, travel, and more Tuition reimbursement & assistance Education & development opportunities including career pathways and coaching Professional clinical advancement program & shared governance Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer Our Values Respect Belonging Accountability Transparency All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made. Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver’s 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, a Public Health Institute, an HMO and The Denver Health Foundation. As Colorado’s primary, and essential, safety-net institution, Denver Health is a mission-driven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community, focusing on hiring and purchasing locally as applicable, serving as a pillar for community needs, and caring for more than 185,000 individuals and 67,000 children a year. Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer. Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community. Applicants will be considered until the position is filled. Denver Health was founded as City Hospital in 1860 to serve the health care needs of the rapidly developing city of Denver. Since then, we have grown alongside the community to become a complete health care system, proudly providing care for all residents -- at every point in their lives. We believe healthy people are the foundation of a vibrant community, and Denver Health has been treating and healing the people of Denver for more than 160 years. Today, Denver Health delivers preventive, primary and acute care services. We are committed to making our community a healthy place to live, work and raise a family. You’ll see that commitment in the programs we offer, through the care we provide and in our determination to achieve continuous improvement so our community always has the best care available. As a comprehensive, integrated organization, we provide hospital and emergency care to the public, regardless of ability to pay. This integration promotes continuity of care for each patient and assures health care that is delivered in the most efficient, cost-effective setting. We care for: thirty-three percent of Denver's population annually; Denver Health sees nearly 1,200,000 total patient visits annually. one in three Denver-area children each year. the needs of special populations such as the poor, uninsured, pregnant teens, persons addicted to alcohol and other substances, victims of violence and the homeless. As Colorado's primary safety-net institution, Denver Health has provided uncompensated care and serves as a model for other safety net institutions across the nation.

Responsibilities

The specialist performs concurrent and retrospective reviews of patient records to ensure documentation accuracy, specificity, and compliance, while also educating providers on documentation requirements and querying physicians when necessary. This role involves close collaboration with departments like Coding, HIM, and Compliance to achieve accurate patient record documentation.