Outpatient Educator-Clinical Documentation Integrity

Conduct provider medical record audits, analysis of practice patterns, education and training regarding risk adjustment to ensure accurate Centers for Medicare amp; Medicaid Service (CMS) payment and improve quality of care. Analysis of medical risk adjustment (MRA) data to identify patterns and develop interventions at the physician and market level. The Outpatient Clinical Documentation Integrity Educator is responsible for conducting coding and billing training to physicians, coders, and other interested personnel, including developing the curriculum and training materials, and assessing competency. Will perform quality assurance reviews/audits with appropriate feedback. Monitors coding and billing regulations to assure compliance with governmental and payer regulations.

For more information email Christina.Stott@hshs.org

Education Qualifications

• Graduate from an accredited and approved school of nursing accepted for licensure in the state of practice is required.
• Bachelor’s degree in Nursing, Health Education, Health Information Management, Healthcare Administration, Business, or related field is required.

Experience Qualifications

• 3 years Hierarchical Condition Category (HCC) coding experience is required.
• Incumbent must have demonstrated prior experience in an managed care environment working with providers on improving clinical documentation and coding in all aspects, to include professional fee (Eamp;M CPT) and diagnosis (HCC Risk Adjustment).

Certifications, Licenses and Registrations

• Registered Nurse (RN) license in the state of practice is required.
• Certified Clinical Documentation Specialist-Outpatient (CCDS-O) is preferred.
• Certified Professional Coder (CPC), or Certified Risk Adjustment Coder (CRC) is required within 12 months of hire.

Job Description

Scheduled Weekly Hours:

40

Throughout communities in Illinois and Wisconsin, 13 hospitals, numerous community-based health centers and clinics, our 13,000 colleagues have built a culture based on our solid core values of respect, care, competence, and joy. These are the ideals we believe in, work by, and live each day.

Built upon more than 145 years of service to the communities we serve, we now look to the future and our place in it as a health care system that strives to continually improve processes, procedures, and outcomes with the latest and most advanced technologies and treatments.

Regardless of how far our passion for excellence carries us, our focus will always remain on the most important person in our entire organization: The patient.

HSHS requires COVID-19 vaccines or an approved medical or religious exemption for all colleagues.

Benefits: HSHS provides a benefits package designed to support the overall well-being of our colleagues including their physical, emotional, financial, spiritual, and work health. Colleagues budgeted to work at least 32 hours per pay period are eligible for HSHS benefits.

• Comprehensive and affordable health coverage includes medical, prescription, dental and vision coverage for full-time and part-time colleagues.
• Paid Time Off (PTO) combines vacation, sick, and personal days into one balance to allow you the flexibility to use your time off as you need.
• Retirement benefits including HSHS
  contributions.
• Education Assistance benefits include up to $4,000 of educational assistance each calendar year and tuition discounts to select colleges with no waiting period.
• Adoption Assistance provides financial support up to $7,500 for colleagues growing their families through adoption to reimburse application and legal fees, transportation, and more!
• Other benefits include: Wellness program with incentives, employer-paid life insurance and short-term and long-term disability coverage, flexible spending accounts, employee assistance program, ID theft coverage, colleague rewards and recognition program, discount program, and more!

https://benefits.hshs.org/newhire

HSHS and affiliates is an Equal Opportunity Employer (EOE).

HSHS is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse workforce.

Pay Range:

$32.58 - $48.87