Clinical Document Integrity Specialist , Managed Care Network Development Med Mgmt

Overview

Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence.

For 26 years, we've been named one of Fortune's 100 Best Companies to Work For, and in the  U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 63 high-performing honors.

At Baptist Health, we’re committed to supporting our employees at every stage of their journey, both personally and professionally. Our approach is rooted in a “grow our own” philosophy, designed to help our team members build meaningful, long-term careers with us, supported by benefits that make a real difference, including:

• Career growth and development opportunities, with clear pathways and ongoing support
• Comprehensive health and wellness resources that go beyond traditional benefits
• A wellness program that can help employees eliminate their medical plan deductible, reducing out-of-pocket healthcare costs
• Tuition reimbursement to support continued learning and advancement
• And so much more

Together, these benefits and others reflect our commitment to caring for our people, so they can build fulfilling careers with us while making a meaningful impact every day.

Responsible for improving the overall quality and completeness of clinical documentation. Facilitates modifications to clinical documentation through extensive interaction with physicians, nursing staff, other patient caregivers, and medical records coding staff to ensure that appropriate reimbursement is received for the level of service rendered to all patients with a DRG based payer. Ensures the accuracy and completeness of clinical information used for measuring and reporting physician and medical center outcomes.

Educates all members of the patient care team on an ongoing basis. Active participation in team meetings and education of staff in the CDMP process is a key role. Estimated salary range for this position is $71940.93 - $93523.21 / year depending on experience.

Degrees:

• Doctor of Medicine / DO.

Additional Qualifications

• Medical Doctor, Doctor of Osteopathic Medicine.
• BSN preferred.
• Three years of recent clinical experience in adult, pediatrics, obstetrics hospital inpatient medical, surgical and critical care setting.
• Knowledge of legal aspects of coding, Medicare MS-DRG, Medicaid APR-DRG assignments, utilization management, case management, discharge planning, and or managed care experience preferred.
• Experience using healthcare web based applications, Milliman, Inter Qual, etc.
• Basic computer skills (familiarity with windows based software programs).
• Incumbents hired prior to 6/4/2023 may be a Certified Coding Specialist or a Registered Nurse to continue in a Clinical Document Spec role.
• Anyone hired after 06/4/2023 must be a Foreign Medical Graduate.

Minimum

Required Experience:

3 Years

EOE, including disability/vets