Clinical Document Integrity Specialist

About the role

Careers at Bayhealth Medical Center are about growth, making a difference, and building a future and a life. We offer competitive salaries, comprehensive benefits, and a variety of practice settings across Kent and Sussex Counties.

Responsibilities

• Completes initial/admission reviews of patient records for a specified patient population to evaluate documentation for accurate DRG assignment, right of mortality, and severity of illness.
• Initiates a query worksheet if clarification is needed.
• Conducts follow-up reviews every 1-2 days of clinical documentation to ensure points of clarification have been recorded in the patient's chart.
• Accurately measures and reports physician and medical center outcomes.
• Educates the healthcare team on specific documentation needs, reporting, and reimbursement issues.
• Collaborates with coding staff to assign a working DRG and documents the Geometric Mean Length of Stay (GMLOS).
• Maintains productivity standards by reviewing 20 cases to produce 5 queries per day.

Requirements

• Requires an RN License.
• A minimum of an Associates Degree in Nursing.
• 5 years acute care experience in med/surg or critical care.

Qualifications

• Knowledge of DRG payor issues, documentation opportunities, clinical documentation requirements, and referral policies and procedures.
• Ability to collaborate and educate members of the healthcare team on specific documentation needs and reporting/reimbursement issues.
• Experience in utilization review, case management, or coding is preferred but not required.

Skills

• Strong clinical expertise.
• Excellent communication skills.
• Proficiency in clinical documentation best practices.

Benefits

• Generous Paid Time Off and Paid Holidays.
• Matching 401(k)/403(b) Plans.
• Excellent Health, Dental, and Vision Insurance.
• Disability and Life Insurance options.
• Health Care and Dependent Care Flexible Spending Accounts.
• Voluntary benefits such as Critical Care Coverage.

Pay

SALARY RANGE: $37.07 - $57.47 per hour.

Schedule

Status: Part Time
Shift: Days
Hours: 48 per bi-weekly period.