Job Description

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.

The Risk Adjustment Clinical Documentation Specialist facilitates accurate, complete, consistent and timely documentation for severity of illness and quality in medical records completed in the physician office setting. This involves extensive record review, interaction with physicians, advanced practitioners, health information management professionals, nursing staff and other physician office staff

JOB DUTIES AND RESPONSIBILITIES:

• Review medical record(s) for completeness, accuracy, consistency and clinical evidence for severity of illness (appropriate capture of true disease burden and quality using official Risk Adjustment and relevant official documentation/coding guidelines.
• Accurate, comprehensive and timely medical record review.
• Consistent and effective use of Compliant Documentation Management Program (CDMP) Risk Adjustment strategies.
• Recognize opportunities for documentation improvement.
• Formulate clinically credible documentation clarifications.
• Request documentation clarifications as appropriate for severity of illness.
• Effective and appropriate communication with Providers.
• Timely follow up on all cases and resolution of those with clinical documentation clarifications.
• Provide routine formal and informal (just-in-time) Risk Adjustment and documentation improvement education to providers/staff.
• Participate in Risk Adjustment steering committee meetings.
• Manage and adjust to changing work volumes and priorities.
• Communicate with HIM and/or billing staff and resolve discrepancies
• Document activity and outcomes accurately, consistently, and in timely manner.
• Participate in data collection, analysis and reporting for program management and performance improvement.

PHYSICIAL AND SENSORY REQUIREMENTS:

Requires sitting, standing and walking for extended periods of time (up to 8 hours at a time). Requires continual use of fingers for writing and computer entry. Routine use of upper extremities; occasional requirement to lift up to 25 pounds. Regularly requires ability to stoop, bend and reach above shoulder level. Requires ability to hear normal conversation and good general, near and peripheral vision.

EDUCATION:

Graduation from a program of nursing. BSN preferred. Certified Coder (COC or CPC) preferred.

TRAINING AND EXPERIENCE:

Required: 5 years of adult acute or ambulatory care experience in med/surg or physician office setting.

Preferred: 1 year of Clinical Documentation Improvement (CDI) experience. Current state Registered Nurse license. Certified Risk Adjustment Coder (CRC)

Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!!

St. Luke's University Health Network is an Equal Opportunity Employer.