MD reviewer

We are seeking a knowledgeable and experienced MD reviewer who will perform review of the records for accuracy of coding and completeness of documentation. Moreover, He or She will also be responsible for reviewing charts for PSI, HAC, Mortality risk adjustment and underpayment prevention. In this role, one will be responsible for integrity of clinical documentation and coding before claims are submitted to the payors. Compliance with federal laws and requirements, education of medical staff members and CDI fellows through constant will be crucial part of this job.
To ensure success, clinical documentation specialists should exhibit extensive experience in a similar role and sound knowledge of clinical documentation regulations. A first-class clinical documentation specialist should be a medical professional whose expertise translates into sound medical recordkeeping practices. This role is 100% remote and with full benefits.

MD reviewer Responsibilities:

  • Applying knowledge of medical terminology and procedures to evaluate clinical documents.
  • Collecting medical information from healthcare providers and updating medical records.
  • Verifying the accuracy of patient medical information and obtaining missing information.
  • Monitoring diagnoses, treatments, and follow-up entries in medical records.
  • Interpreting and preparing clinical reports for healthcare professionals and public health officials.
  • Knowledge of Patient Safety Indicators (PSIs), Hospital Acquired Conditions (HACs) and Risk Adjustment is must.
  • Knowledge about Post-Acute Care DRG rule is preferred.
  • Ensuring that the content and storage of medical documents comply with federal laws.
  • Training medical and administrative staff in standard medical recordkeeping procedures.
  • Keeping abreast of advancements in the field of clinical documentation and changes in regulations.

MD reviewer Specialist Requirements:

  • Medical Graduate, MD, MBBS or equivalent
  • CCS credential is required
  • Familiarity with case management is preferred
  • At least 2 year of clinical and coding audit experience is required.
  • Advance knowledge of Clinical pathophysiology, anatomy and basic guidelines
  • Proficiency working with Microsoft office tools including Excel.
  • Advanced knowledge of best practices in Documentation and coding
  • In-depth knowledge of medical terminology, coding, and procedures
  • Advancing knowledge in quality outcomes, PSI, HAC, Mortality reviews and Risk Adjustment
  • Extensive experience in collecting and interpreting medical information, as well as training staff.
  • Ability to keep informed of advancements and regulations in clinical documentation and coding compliance
  • Excellent organizational and communication skills.

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