General Summary of Position
The Clinical Documentation Physician Advisor will function within MedStar Health's Clinical Documentation Improvement Department to ensure that clinical documentation data capture practices are compliant, efficient, accurate and consistent. Accepts a commitment to the values expressed in the MedStar Health's mission statement "to serve our patients, those who care for them, and our communities". Demonstrates behavior consistent with the MedStar values and contributes to the expected positive climate within the healthcare system, working well with both physicians, executives, and subordinates. Performs his/her job function in a way that makes him/her a recognized expert for affiliated hospital, physicians, and other entities. Develops the trust and confidence of Clinical Documentation Improvement stakeholders and becomes the resource of choice for the coding compliance and hospital coder and clinical questions. Develops a trust and confidence of the COO, CFO and other market and divisional managers with accountability for coding within assigned geographic areas.
Primary Duties and Responsibilities
Provides leadership and direction as needed to the CDI Director and staff on issues related to clinical documentation improvement, disease process, corporate compliance, projects and other initiatives.
Analyzes the effectiveness and efficiency of clinical documentation processes and advises COO and CFO on mechanisms to improve efficiency and effectiveness. Serves as a resource for CDI staff.
Performs regular/daily query clarification and escalation as assigned.Works with Clinical Documentation Improvement team to periodically analyze MS-DRG data, MDC and ICD-10 to identify variations and determine the cause and the appropriateness of such variation and presents such findings to COO, CFO and departmental directors. At the request of the COO, CFO, and other management, evaluates systems and processes related to or impacting coding and recommend system process improvements, which will enhance the organization's efficiency.
Develops a trust and confidence of the COO, CFO and other market and divisional managers with accountability for coding within assigned geographic areas.
At the request of the COO, CFO, and other management, evaluates systems and processes related to or impacting coding and recommend system process improvements, which will enhance the organization's efficiency.
Ensures that data collection is performed in a manner consistent with relevant laws, regulations and standards. Participate in a Presents education programs on a regular basis designed to improve the accuracy and specificity of clinical documentation to clinical documentation specialists (CDSs), physicians, mid-levels and others.Is a reliable resource for CDSs and physicians who are involved in CDI/Quality work, providing advice on MS-DRG and APR-DRG assignment, as well as SOl/ROM, PSI90, MHACs, POA conditions, and other related topicsAssists with the implementation and adoption of a formal escalation policy, ensuring that it is understood and adopted by the organization's medical staff. Serves as the initial escalation step, per policy, if physician response is not met by a determined amount of time.Manages and coordinates with national CDI Directors on specific clinical documentation and coding compliance accountability issues.
Minimum Qualifications
Education
- Doctoral degree Graduate from an accredited medical school listed in the World Directory of Medical Schools required
Experience
- 5-7 years Acute care Clinical Documentation Integrity experience required
Licenses and Certifications
- MD - Physician - State Licensure in Maryland and/or DC required
- CCDS - Certified Clinical Documentation Specialist preferred
- CDIP - Clinical Documentation Improvement Practitioner preferred
- CCS-Certified Coding Specialist preferred
Knowledge, Skills, and Abilities
- Strong telephone communication skills.
- Ability to work independently.
- Must possess strong organizational skills.
- Ability to communicate clearly in a verbal and written manner.
- Ability to work independently and be self-motivated.
- Ability to solve and resolve complex problems.
- Basic computer skills.
- Managing one's own time and the time of others.
- Knowledgeable of medical electronic information registration and appointment scheduling systems.
- Demonstrated ability to work effectively in a team environment
- Computer skills including Microsoft Office, Power Point, Excel, Word.
- Basic computer skills required.
- Excellent interpersonal and collaborative skills and the ability to develop and maintain positive working relationships are essential.
- Ability to work in a fast-paced environment.
- Ability to communicate clearly in a verbal and written manner.
- Ability to solve and resolve complex problems.
- Ability to work independently and be self-motivated.
- Managing one's own time and the time of others.
- Demonstrated ability to work effectively in a team environment
- Working knowledge of payer policies, HCFA policies, local and national regulatory and compliance policy, knowledge of all available coding resources.
- Adjusting actions in relation to others' actions.
- Strong interpersonal and physician leadership skills.
- Excellent oral/ written skills.
- Demonstrated ability to communicate and educate providers regarding principles of utilization management and quality assurance.
- Demonstrated ability to provide excellent customer service.
- Ability to toggle between specialty coding disciplines, including ancillary services, Anesthesia, Emergency Medicine, Radiology, Pathology and others.
- Ability to multitask and work cooperatively with others.
- Demonstrated ability to be organized and efficient in prioritizing and managing assignments within minimal oversight and direction.
- Demonstrated skills in clinical judgment.
- Ability to present information clearly and concisely.
This position has a hiring range of $180,000 - $200,000
