Clinical Documentation Specialist; Hybrid

Job Description General Purpose of Job:

The UMHP Clinical Documentation Specialist (CDS) is responsible for planning, coordinating and providing education related to clinical documentation improvement and clinical charge capture optimization for their assigned UM Health Partners market service line physicians, APPs and staff. The CDS will improve and optimize workflows and processes related to the education, analysis, maintenance and support of charging, coding, documentation, , Annual Wellness Visits (AWVs), prior authorization, modifier usage trends/development, portal messaging and CPT/ICD-10 and HCC code usage for UMHP to achieve best in class.

The CDS will apply their knowledge of medical terminology and coding to develop workflows, implement education plans and communicate the principles and importance of accurate and complete documentation to support charging for outpatient professional clinical visits/services, surgeries, procedures and imaging studies. The CDS identifies gaps and opportunities for charge capture and partners with the medical and service line leadership on the implementation of processes in the ambulatory clinical setting.

The CDS understands and articulates data analysis specific to physician and APP clinical documentation, charge capture and revenue activity, provides updates on status and progress of efforts to improve revenue capture, and maintains a strong collaborative relationship with the Clinically Integrated Network (CIN) and other relevant departments.

This job description is intended to cover the minimum essential duties assigned on a regular basis. Team members may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.

• Assists in the design, implementation, education and evaluation of tools and resources to assist providers with efficient and effective documentation, accurate coding and charge capture opportunities. All coding edits and/or revisions including claim submission are the sole responsibility of the HIM and billing teams. All coding education will be approved by Compliance prior to implementation.
• Provides coding and documentation education for physicians and APP’s.
• Collaborates on education efforts.
• Develops upstream coding, documentation, charge capture, education approach focused on new departments and emphasizing new specialty areas to increase knowledge and establish sustainable best practices early on.
• Assists in onboarding process for physicians and APPs with orientation to documentation, coding and charge capture excellence, establishing a 3-to-9-month check-in/assessment process with all recently onboarded providers ensuring appropriate charge capture check-ins.
• Communicates with UMHP service line leaders, provider champions, physicians and APPs regarding clinical documentation and medical coding for patient care services.
• Prepares and analyzes reports to provide feedback on provider and coding performance including state of documentation, charge capture and reconciliation.
• Identifies Return on Investment, documentation trends and priority areas/pain points to share with site/service line leadership to allow for clinician education. Prepares case and specific documentation examples/presentations to share at department meetings.
• Analyzes data to prioritize areas of wRVU recovery.
• Assists with UMHP and department initiatives to improve revenue, centralize outpatient prior authorization processes and reduce avoidable write-offs.
• Assists with the strategic development of outpatient charge capture optimization (i.e. professional clinical visits/services, surgeries, procedures and imaging studies), and facilitates change processes required.
• Perf…