Surgery Reimbursement Specialist (1.0) bei Franciscan Alliance
Franciscan Alliance · Munster, Vereinigte Staaten Von Amerika · Onsite
- Professional
- Optionales Büro in Munster
The Clinical Document Specialist is responsible for improving the overall quality and completeness of clinical documentation. In this role you will facilitate modifications to clinical documentation through extensive concurrent interaction with physicians and coding staff to ensure that the record accurately reflects the diagnosis treated, procedures performed and the severity of illness of the patient.
WHO WE ARE
With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.
WHAT YOU CAN EXPECT
Communicate with physicians, regarding missing, unclear or conflicting medical record documentation through the query process to clarify the information, obtain needed documentation, present opportunities, and educate for appropriate identification of severity of illness.
Communicate with physicians, case managers, coders, and other healthcare team members to facilitate comprehensive medical record documentation ensuring they reflect clinical treatment, decisions, and diagnoses for inpatients.
Utilize your expertise in understanding of complications, co-morbidities, the severity of illness, the risk of mortality, case mix, secondary diagnosis, and the impact of procedures on the final DRG; and share this knowledge to physicians and other members of the healthcare team.
Identify patterns, trends, variances, and opportunities to improve the documentation review and process.
QUALIFICATIONS
Associate's Degree Nursing or Healthcare related field - Required
Bachelor's Degree Nursing or Healthcare related field - Preferred
Registered Nurse (RN) - State Licensing Board - Required
Certified Clinical Documentation Specialist (CCDS) - Association of Clinical Documentation Integrity Specialists (ACDIS) - Preferred
7 years acute care nursing in lieu of Bachelor's Degree - Required
2 years Recent inpatient, case management, or ED - Required
Experience assisting with insurance authorization approvals and payer follow-up - Required
Skilled in validating surgical cases and verifying proper scheduling documentation - Required
Strong understanding of CPT coding and surgical billing practices to ensure accurate reimbursement - Required
Knowledge of healthcare finance, reimbursement processes, and denial management - Required
Demonstrated ability to optimize financial outcomes through accurate coding and documentation practices - Required
Proven ability to identify process improvements and support standardization of surgical procedures and supplies - Required
Excellent communication skills and ability to collaborate effectively with nursing staff, physicians, and administrative teams - Required
TRAVEL IS REQUIRED:
EQUAL OPPORTUNITY EMPLOYER
It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.
Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.
Franciscan Alliance is committed to equal employment opportunity.
Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.
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