We are an academic acute care medical center looking for a Licensed NY Medical Physician Advisor to join our established Clinical Documentation Integrity department. As the MD Physician Advisor, you will work closely with the current Physician Advisor acting as a liaison between the Clinical Documentation Integrity (CDI), Health Information Management (HIM), Quality, and the hospital’s medical staff to facilitate accurate and complete documentation. Reviews documentation for quality programs, abstraction of clinical data capturing of severity, acuity, and risk of mortality, in addition to DRG assignment. The physician advisor helps facilitate training for the physicians and define clinical conditions to be used for CDI.
Position: Medical Doctor Physician Advisor
Location: Remote
Salary: $250,000 to $275,000
Responsibilities:
Reviews mortality and readmission cases to ensure correct clinical principal diagnoses and severity of illness capture along with working with the Documentation Integrity and HIM Coding personnel, on a routine basis, to review quality events that are based on ICD-10 code assignments to ensure clinical accuracy.
Assists in auditing for clinically appropriate and compliant physician queries and assists in the development of education materials for the CDI team and medical staff departments.
Provides feedback to facility attending and consulting physicians for process improvement efforts regarding admission status, level of care, length of stay, medical necessity documentation, and quality issues. Seeks additional clinical information from the attending and consulting physicians.
Recommends and requests additional, more complete, medical record documentation to satisfy payer contract requirements and recommends next steps in the coordination of care and evidence-based medicine indicators.
Documents patient care reviews, decisions, and other pertinent information. Understands and uses appropriate criteria. Documents response to referrals. Supports CDI in a data-driven approach.
Requirements:
Must be a Medical Doctor licensed to practice medicine in the State of NY with clinical experience
Knowledge of clinical documentation guidelines and regulatory requirements and working knowledge of state and federal regulations regarding fraud and abuse laws.
Knowledge of quality measures including HAC, HARM, HCC, and Risk Adjustment methodologies to reviews ensuring appropriate data submission.
Proficiency in PSI 90, mortality reviews, and readmission data.
Advanced knowledge of researching coding related issues. (i.e. coding clinics, coding guidelines, etc.)
Work collaboratively with physicians, nurses, and other healthcare providers to improve documentation practices and ensure accuracy of clinical documentation.
Location: Yonkers, NY
Posted: Sept. 16, 2024, 7:23 a.m.
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