Clinical Documentation Specialist - CDI exp preferred

If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One!

We strive to be an employer of choice and establish a reputation for being a talent rich organization where Associates can grow their career caring for others. For over a century, we’ve served the health care needs of the people of Memphis and the Mid-South.

Responsible for daily interaction with physicians and practitioners to assign ICD-10-CM codes and obtain documentation. Evaluates documentation, communicates with physicians and other healthcare team members, acts as a resource in educating others and gathers/analyzes information pertinent to documentation findings and outcomes. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.

Working at MLH means carrying the mission forward of caring for our community and impacting the lives of patients in every way through compassion, a deliberate focus on service expectations and a consistent thriving for excellence.

A Brief Overview
Responsible for daily interaction with physicians and practitioners to assign ICD-10-CM codes and obtain documentation. Evaluates documentation, communicates with physicians and other healthcare team members, acts as a resource in educating others and gathers/analyzes information pertinent to documentation findings and outcomes. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.

What you will do

• Provides clinical evaluation of the medical record to facilitate capture of comprehensive medical record information to reflect clinical treatment, decisions, and diagnoses for inpatients.
• Responsible for the day-to-day evaluation of documentation by the medical staff and healthcare team in accordance with the hospital’s designated clinical documentation system.
• Communicates with physicians and others to obtain appropriate information. Gathers and analyze information pertinent to documentation findings and outcomes.
• Provides or coordinates ongoing education to internal customers related to compliance, coding, and clinical documentation issues and acts as consultant to coders when additional information or documentation is needed to assign the correct DRG.
• Develops physician education strategies to promote complete and accurate clinical documentation and correct negative trends.
• Performs other job duties as assigned or requested.

Education Qualifications

• High School Diploma or Equivalent required
• Technical Degree or Diploma Medical Coding preferred
• Bachelor's Degree Nursing- RN preferred
• Bachelor's Degree Health Information Management preferred

Experience Qualifications

• 5-7 years Clinical healthcare or
• 5-7 years Patient coding five (5) years in patient coding experience with advanced clinical expertise and extensive knowledge of complex disease processes with a broad clinical experience in an inpatient setting.

Skills and Abilities

• Knowledge of DRG, ICD-10 and CPT coding relative to physician clinical documentation.
• In depth understanding of anatomy, physiology, medical terminology, and disease processes required.
• Excellent verbal and written communication skills.
• Proficiency in organization and planning.
• Proficiency in computer usage including database and spreadsheet analysis, presentation programs, word processing and Internet searching.
• Working knowledge of quality improvement theory and practice.
• Ability and willingness to seek out and accept change.
• Demonstrates adaptability and self-motivation by staying abreast of CMS rules and regulations and incorporating those changes into daily practice.
• Knowledge of federal, state and private payer regulations

Licenses and Certifications

• Certified Coding Specialist - American Health Information Management Association
• Registered Health Information Administrator - American Health Information Management Association
• Registered Health Information Technician - American Health Information Management Association
• Registered Nurse Arkansas - Arkansas State Board of Nursing
• Registered Nurse Mississippi - Mississippi Board of Nursing
• Registered Nurse Tennessee - Tennessee Board of Nursing

Supervision Provided by this Position

• There are no supervisory or lead responsibilities assigned to this position.

Physical Demands

• The physical activities of this position may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion.
• Must have good balance and coordination.
• The physical requirements of this position are: light work - exerting up to 25 lbs. of force occasionally and/or up to 10 lbs. of force frequently.
• The Associate is required to have close visual acuity to perform an activity, such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.
• The conditions to which the Associate will be subject in this position: The Associate is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative work.

Our Associates are passionate about what they do, the service they provide and the patients they serve. We value family, team and a Power of One culture that requires commitment to the highest standards of care and unity.

Boasting one of the South's largest medical centers, Memphis blends a friendly community, a thriving and growing downtown, and a low cost of living. We see each day as a new opportunity to make a difference in the lives of the people in our community.