Clinical Document Specialist Ambulatory
Company: Novant Health
Location: Wilmington
Posted on: May 25, 2023
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Job Description:
Overview:***NON REMOTE ROLE*** MUST LIVE IN WILMINGTON, NC The
Ambulatory Clinical Documentation Specialist (CDS) core functions
include assessing, planning and implementing individual, specific
education to clinicians, validating payer contract performance
around HCC capture and recapture, and participating in the annual
CMS Quality Payment Program reporting process. The Ambulatory CDS
develops individual specific education for clinicians regarding
Risk Adjustment methodology (impact of Risk Adjustment Factor (RAF)
and Hierarchical Condition Category (HCC)), coding and
documentation guidelines and requirements as well as service line
specific requirements, to clinicians. Clinicians include
physicians, APPs and clinical staff. Performed via face to face
encounters in small and large group settings as well as
electronically. The CDS uses clinical/nursing knowledge, and
understanding of coding guidelines (ICD-10-CM, CPT and HCPCS Level
II) and standards of compliance to improve overall quality and
completeness of clinical documentation within the patient
electronic medical record (EMR). Works collaboratively with all
clinicians to ensure documentation is accurate, complete and
compliant with coding guidelines and requirements. Accomplished
through the review of the complete patient EMR for coding and
documentation specificity, formulating queries, as appropriate.
Ambulatory CDS review and validate specific payer patient lists on
an ongoing basis, utilizing clinical and coding knowledge, to
maximize payer contract benchmarks for shared savings around HCC
capture and recapture rates. Also identify opportunities for
provider education to share with the CDI team. The Ambulatory CDS
participates in annual Quality Payment Program data extraction for
submission to the Center for Medicare/Medicaid Services (CMS). Must
participate in multiple measure data extractions as needed for
timely submission of data reporting to CMS. Ability to identify
areas for measure improvement to report out trends to leadership.
At Novant Health, one of our core values is diversity and
inclusion. By engaging the strengths and talents of each team
member, we ensure a strong organization capable of providing
remarkable healthcare to our patients, families and communities.
Therefore, we invite applicants from all group dynamics to apply to
our exciting career opportunities.Qualifications:
Keywords: Novant Health, Wilmington , Clinical Document Specialist Ambulatory, Healthcare , Wilmington, North Carolina
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