[Remote] Quality Clinical Documentation Improvement RN

Note: The job is a remote job and is open to candidates in USA. CommonSpirit Health is a large health system with care centers throughout California. The Quality Clinical Documentation Improvement RN is responsible for reviewing ambulatory medical records for documentation compliance and providing education to providers while identifying trends and opportunities for improvement. Responsibilities • Reviews high volume of EMR medical records to determine if specific conditions were assessed and documented appropriately; Follows department policies and guidelines on appropriate documentation to billing codes, abstracting information from chart notes based on performance program measures • Identifies claims correction opportunities and submit to appropriate personnel for processing in a timely manner within pre-set acceptable accuracy levels. Tracks trends for each physician to identify potential training areas. • Maintains accurate, timely tracking of physician documentation performance using established tools within the department; Alerts management when low performance trends occur. • Participates with third-party collaborator to identify trends and to address and resolve gaps in performance standards. • Provides chart review guidance and education to team regarding appropriate chart review methodology when necessary; Performs secondary chart reviews when applicable to clarify compliance to coding guidelines. Skills • 3-5 years post licensure experience. • Satisfactory completion of a formal Registered Nurse program pursuant to the Division of Allied Health Professions or military training that is equivalent to an accredited Registered Nurse program (determination by Dignity Health Medical Foundation HR department in conjunction with the State Division of Allied Health Professions). • Clear and current CA Registered Nurse (RN) license. • Familiarity with an electronic practice management system/EMR. • Ability to independently assess, evaluate and interpret clinical information. • Ability to identify claim correction opportunities via detailed chart reviews. • Demonstrated analytical skills, including the ability to understand clinical compliance guidelines, complex reimbursement structures and the ability to apply contractual and governmental regulations to internal processes. • Must possess excellent verbal, written, and interpersonal skills. • Strong organizational and time management skills. • Mature judgement, self-motivated, and ability to work independently. • Schedule, organize, and complete work in accordance with deadlines. • Ability to collaborate effectively with all levels of staff. • Must possess basic computer skills with Microsoft Word and Excel. • Clinical training in an acute care or ambulatory environment. • Clinical training in managed care capitated healthcare environment. • 3-5 years broad clinical experience in an ambulatory setting preferred. • Certified Professional Coder (CPC) preferred. Education Requirements • Bachelors of Nursing (BSN) preferred. Company Overview • Common Spirit Health is a healthcare organization that provides research programs, home health programs, and virtual care services. It is a sub-organization of CommonSpirit Health. It was founded in 2019, and is headquartered in Chicago, Illinois, USA, with a workforce of 10001+ employees. Its website is https://www.commonspirit.org. Apply tot his job Apply To this Job