What are the responsibilities and job description for the Provider Documentation Specialist position at ConvenientMD?
At ConvenientMD, we're on a mission to make good health more convenient for all – working to improve how patients and providers experience healthcare in New England. To support this belief, we're building a team of dedicated professionals who genuinely care about improving lives, are passionate about work that can make a difference, and are driven to learn from one another.
The Opportunity
The Provider Documentation Specialist plays a critical role in reviewing, enhancing, and ensuring the accuracy of clinical documentation provided by healthcare providers. This position ensures that medical records adhere to regulatory requirements, coding standards (such as ICD-10 and CPT), and payer guidelines, optimizing reimbursement and supporting high-quality patient care.
Your Impact
- Documentation Review and Quality Assurance
- Review clinical documentation to ensure it accurately reflects patient care, diagnoses, procedures, and treatment plans.
- Identify and resolve gaps or inconsistencies in clinical documentation affecting coding, billing, or regulatory compliance.
- Ensure documentation meets payer, accreditation, and government regulatory standards.
- Collaboration with Providers
- Partner with physicians, nurses, and other healthcare providers to clarify documentation or request additional information.
- Provide feedback and education to providers on best documentation practices and how to avoid common errors or omissions.
- Assist providers in understanding documentation guidelines, coding standards, and how accurate documentation impacts reimbursement.
- Compliance and Regulatory Adherence
- Ensure clinical documentation complies with HIPAA, CMS (Centers for Medicare & Medicaid Services) guidelines, and payer-specific requirements.
- Educate providers on regulatory updates, clinical documentation policies, and coding changes (e.g., ICD-10, CPT).
- Support organizational compliance efforts during audits, ensuring proper documentation is maintained.
- Coding and Reimbursement Support
- Ensure clinical documentation supports accurate and complete medical coding, aiding proper reimbursement processes.
- Collaborate with coding specialists to verify that all diagnoses, treatments, and procedures are correctly documented and coded.
- Identify opportunities for improving coding practices and revenue cycle management by providing feedback on documentation.
- Training and Education
- Conduct training sessions for healthcare providers on proper documentation practices, emphasizing accuracy and its impact on patient care and reimbursement.
- Provide ongoing support and feedback to improve documentation quality, focusing on clinical detail, specificity, and consistency.
- Audit Support
- Assist in internal and external audits related to clinical documentation and coding accuracy.
- Prepare and provide documentation for audits, addressing discrepancies or gaps identified by auditors.
- Continuous Improvement
- Participate in initiatives to enhance clinical documentation quality across the organization.
- Suggest improvements to documentation processes, templates, or systems to boost efficiency and ensure record integrity.
- Stay updated on changes in healthcare regulations, coding practices, and documentation standards.
- Reporting and Documentation Tracking
- Track and report documentation issues, trends, and improvement initiatives.
- Maintain accurate records of interactions with healthcare providers regarding documentation corrections and improvements.
Why ConvenientMD?
- Collaborative team environment that encourages professional growth
- Urgent care services at no cost to our team members and their families
- Extensive benefit offerings including health, dental, and vision coverage, company paid short-term disability, and optional pet insurance
- 401k match after one year of service
- Access to our primary care (depending on location)
- Educational Alliance with Purdue University Global and reduced tuition rates for team members and their families
- Employer rewards and access to discounts offered on services and products such as hotels, travel, entertainment, restaurants, and more
There's a job and then there's purposeful, transformative work. Our aim is to create a workplace where you can learn, grow, and continuously refine your skills. Applicants rarely meet every single job requirement, and we appreciate that many skills and backgrounds can make people successful in this role. We are committed to creating a strong sense of belonging for all team members, and our process is designed to prevent discrimination against applicants regardless of gender identity, sexual orientation, religion, ethnicity, age, disability status, or any other aspect which makes you unique. If you're looking for a great next step, and want to feel good about what you do, we'd love to hear from you.
