Description
Responsibilities
The Managed Care Analytics department exists to monitor and improve the financial performance of Kelsey-Seybold's (KS) product lines and health plans. The MCA Risk Adjustment Clinical Documentation Specialist team is a highly-skilled team of Clinical Documentation Specialist in the outpatient setting providing chart review services and consultation to the KS Executive team as well as to physicians and physician leadership through the Risk Adjustment program which is designed to impact revenue through compliant, accurate and complete diagnosis assessment and medical documentation.
The Clinical Documentation Specialist ensures the accurate and complete assessment of chronic conditions which fall into the HCC model as required by CMS for Medicare Advantage plans or other risk-adjusted methodologies through chart review. The primary functions of this role include:
Performs complex reviews of patient?s medical documentation, evaluating quality measures, consistency, completeness of documents, and accuracy for severity of illness (SOI)
Maintain knowledge of HCC documentation updates
Communicate with physicians for feedback, documentation improvement, and clarification requests
Serves as a resource for other clinical documentation specialist outpatient team members
Job Title: Clinical Documentation Specialist Outpatient
Location: Pearland Administrative Office
Department: KS Plan Advantage-Risk Adjustm
Job Type: Full Time
Salary Range: $ 64,369 - $79,496 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)
Qualifications
Education
Required: Associates degree, Clinical documentation program, Clinical licensure program, or equivalent
experience
Preferred: Bachelor of Nursing degree or Master of Nursing Program
Experience
Required: 3+ years in clinical documentation or related field with 3+ years in HCC Coding
Preferred: N/A
License(s)
Required: Certified Risk Adjustment Coder (CRC) or Certified Documentation Education Outpatient (CDEO
Preferred: LVN, RN, RHIT, RHIA
Special Skills
Required: Attention to detail
Excellent problem solving, written and verbal communication skills
Strong time management skills
Ability to shift between tasks without losing productivity
Experience with EPIC EMR
Preferred: Experience in multi-specialty setting
Proficient in Word, Excel and Outlook
Other
Required: Ability to travel regionally up to 25%
Preferred: N/A
Working Environment: Office
About Us
Start your career journey and become a part of a community of renowned Healthcare professionals. Kelsey-Seybold Clinic is Houston?s fastest growing, multispecialty organization with more than 40 premier locations and over 65 specialties. Our clinics are comprised of more than 600 physicians and as we continue to grow, our focus is providing quality patient care by adding to our team of clinical and non-clinical professionals that work together in a convenient, coordinated, and collaborative manner. Enjoy the rewards of a successful career while maintaining a work/life balance by joining our team today and changing the way health cares.
Why Kelsey-Seybold Clinic?
- Medical, Vision, and Dental
- Tuition Reimbursement
- Company Matching 401K
- Employee Reward and Recognition Program
- Paid time off for vacation, sick, and holidays
- Employee Assistance Program
- Continuing Medical Education allowance
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