Clinical Documentation Analyst Jobs

KORE1, a nationwide provider of staffing and recruiting solutions, has an immediate opening for a Clinical Documentation Analyst in San Gabriel Valley, CA.

Summary:

A key objective of the Clinical Documentation Analyst is to gather, review and provide clinical documentation to third party payers in support of the services provided to patients. In addition, the Clinical Documentation Analyst analyzes charge transactions along with documentation to properly bill for related services provided to the patient. The Clinical Documentation Analyst also serves as a patient advocate and promotes customer satisfaction by appropriately explaining and resolving charge discrepancies. The Analyst participates in departmental and organizational performance improvement activities and appropriately communicates audit findings.

Essential Functions:

• Interprets and explains to patients or family members the details of medical services provided, if requested
• Development and maintenance of collaborative working relationship with Revenue Cycle departments and clinical personnel on issues related to the charge master and charge capture related processes
• Any other audit/miscellaneous charge capture duties assigned
• Development of policies and procedures for timely and accurate charge capture mechanisms; Prepares report of findings for management
• RN or Certified Coding (CCS, CPC)
• Interprets and explains to patients or family members the details of medical services provided, if requested.
• Working knowledge of hospital patient billing and managed care systems.
• Development of action plan with responsible parties and due dates of issues identified;
• Maintains a record of audit/reconciliation account activity and takes appropriate follow-up actions
• High school diploma or GED required; Associate's or equivalent experience required; Bachelor's preferred
• Excellent oral/written communication skills
• Coordinates/conducts entrance and exit audit interviews with third party payers in relation to patient bills. Recommends to management the appropriate actions and strategies to be taken.
• Insurance/contract billing and collections. Epic experience preferred
• Reviews and analyzes data required for internal and external audits as directed
• Maintains a record of audit/reconciliation account activity and takes appropriate follow-up actions
• Improvement of department processes and procedures to assure timely and accurate capture of all chargeable activities;
• Five years current related experience in an acute care facility or 4 years of experience in Coding, Revenue Integrity or UR/Case Mgmt
• Work effectively with third party payers.
• Reviews medical records for appropriate documentation to appeal proposed clinical and technical denials
• Conducts department in-service training on an as needed basis.
• RN, coder or equivalent clinical documentation background
• Analyzes charge transactions along with documentation to properly bill for related services provided to the patient; Assist with review and perform manual charge entry/correction as needed
• Conducts special patient charge studies. Develops data and provides interpretation of intangible or unusual factors and summarizes findings appropriately.
• In-depth knowledge of medical record documentation.
• Verifies medical procedure documentation and completeness of the Medical Record. Requests documentation as needed to support charges.
• Conducts department in-service training on an as needed basis
• Participates collaboratively with Revenue Cycle team and hospital staff on issues related to the charge master and charge capture related processes
• Requests documentation as needed from clinicians/providers to support charges.
• Foster and promote a positive image and professional appearance

About Kore1

Specializing in professional and technical recruiting, KORE1 is committed to supporting top IT, Engineering, Creative, Scientific, Accounting and Finance professionals in their career paths. We build deep relationships with leading companies, connecting them to exceptional talent every day. With extensive industry expertise and unmatched opportunities, our goal is to provide a unique experience for our contractors and consultants as they prepare for their next role. We are passionate about matching the right people with the right companies.

Kore1 provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Kore1 complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Kore1 expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Kore1's employees to perform their job duties may result in discipline up to and including discharge.