Group Clinical Documentation Specialist
Prime Healthcare
Group Clinical Documentation Specialist
Prime Healthcare
Acquires and reorganizes underperforming hospitals
The Group Clinical Documentation Specialist (Group CDS) is responsible for conducting clinically based concurrent and retrospective reviews of medical records. This review is to evaluate that the clinical documentation is reflective of the quality-of-care outcomes and reimbursement compliance for healthcare providers’ services provided. The Group CDS will work closely with the medical staff to facilitate appropriate clinical documentation of patient care. Other responsibilities include conducting documentation review and monitoring for Physician Quality Reporting Standards, CMS HCC documentation and coding audits on all selected visits and documenting findings. Other responsibilities included as designated by the reporting team.
EDUCATION, EXPERIENCE, TRAINING
Required qualifications:
1. Medical Graduate or bachelor’s degree in healthcare, or related field
2. Excellent critical thinking, written and verbal communication skills
3. Excellent interpersonal skills to build effective partnering relationships with physicians, nurse staff, coding staff and management staff.
4. Ability to work independently in a time-oriented environment.
5. Basic computer experience & familiarity with the operation of basic office equipment.
Preferred qualifications:
1. Master’s degree in any healthcare related field
2. ECFMG Certificate
3. Minimum of one-year clinical experience in acute care setting
4. Experience in ICD-10 and CPT coding in the outpatient setting
Prime Healthcare Illinois Medical Group offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $28.00 to $43.40. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
The company is dedicated to empowering its staff with a comprehensive, competitive benefits package, allowing them the freedom to customize their benefits to fit their unique needs. Our abundant resources, programs, and voluntary options serve as a foundation for individual growth and well-being. Learn more here: https://www.primehealthcare.com/benefitsthatmattermost/
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
Acquires and reorganizes underperforming hospitals
Prime Healthcare operates a network of hospitals and outpatient centers across the United States, concentrating on turning around financially struggling facilities. It invests in infrastructure and technology, restructures operations, and negotiates payer terms (including pursuing higher out-of-network reimbursements) to improve financial performance, and it manages both for-profit hospitals and not-for-profit facilities through the Prime Healthcare Foundation. The company aims to raise clinical quality and patient safety while expanding access in hundreds of communities, though it has faced legal and regulatory scrutiny over billing practices and service-line decisions. Its goal is to stabilize and improve the financial and clinical performance of underperforming hospitals so they can continue serving their communities.
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