Second Level Reviewer I

About the role

Joining AdventHealth is about extending the healing ministry of Christ. This position is part of a community dedicated to the wholeness of each person, serving to uplift them in body, mind, and spirit.

Responsibilities

• Recognizes opportunities for documentation improvement using strong critical-thinking skills and formulates clinically credible clarifications for inpatients.
• Transcribes documentation clarifications as appropriate to ensure documentation compliance.
• Educates members of the patient-care team regarding documentation regulations and guidelines, including physicians, allied health practitioners, and nursing staff.
• Communicates effectively with physicians and other healthcare providers to ensure appropriate, accurate, and complete clinical documentation.
• Collaborates with health information management staff to resolve discrepancies with diagnostic assignments and other coding issues.
• Completes well-timed follow-up case reviews on all cases, prioritizing those with clinical documentation clarifications.
• Participates in department meetings, providing feedback on outstanding issues and presenting educational opportunities.
• Assumes personal responsibility for professional growth, development, and continuing education to maintain a high level of proficiency.
• Assists in new hire orientation through precepting and mentoring.
• Maintains regional productivity standards and demonstrates competence on compliance audit scores.
• Maintains a 97% physician response rate to all valid clarifications.
• Annual participation in Advanced Practice call.
• Maintains CCDS credentialing.
• Reviews concurrent medical records for documentation compliance, including completeness, accuracy and quality.
• Inputs data accurately and concisely into assigned software, resulting in accurate metrics obtained through the reconciliation process.

Qualifications

• Knowledge of clinical documentation requirements that identify clinical conditions or procedures.
• Coding background.
• Knowledge of quality guidelines.
• Education: Bachelor's of Nursing [Required], Master's [Preferred] in healthcare related field.
• Work Experience: 5+ years acute care nursing experience with specific medical/surgical, Intensive Care, post-acute care unit, or Emergency Department experience. [Required], 3+ years of Clinical Documentation Specialist experience [Required].
• Licenses and Certifications: Registered Nurse (RN) [Required], Adult Acute Care Nurse Practitioner (ACNPC) [Required], Physician Assistant (PA) [Required], Certified Clinical Documentation Specialist (CCDS) [Required], Certified Documentation Improvement Practitioner (CDIP) [Required], Certified Coding Specialist (CCS) [Preferred].

Skills

• Excellent interpersonal skills including excellent verbal and written communication skills; proficient in and demonstrates excellent physician relations.
• Able to organize and present information clearly and concisely.
• Excellent computer and keyboarding skills; ability to use multiple software programs simultaneously; high degree of prioritization skills.
• Ability to learn/develop and fine-tune the skills necessary to perform optimally as a Clinical Documentation Specialist.
• Dependable, self-motivated, and pleasant.
• Utilize and demonstrate excellent critical-thinking, problem-solving and deductive-reasoning skills.
• Knowledge of pathophysiology, disease processes and treatments.
• Strong ability to organize/triage work and manage multiple priorities at once.

Benefits

• All the benefits and perks you need for you and your family: Benefits from Day One, Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance, Paid Time Off from Day One, 403-B Retirement Plan, Whole Person Well-being Resources, Mental Health Resources and Support, Pet Benefits.
• Schedule: Full time Shift Day (United States of America).

Pay

$66,170.74 - $123,073.07

Physical Requirements

Click here to view physical requirements

Additional Information

An equivalent combination of education and relevant work experience may be considered in lieu of the stated degree requirement:

• BSN and 3+ years of Clinical Documentation Specialist experience OR
• 4+ years of Clinical Documentation Specialist experience OR
• Less than 2 years of Clinical Documentation Integrity experience and 10 years of acute care nursing experience.

Background Screening Requirement

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Equal Opportunity Employer

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.