Claro, ProFee Chart Review Specialist - Chicago, United States - Kaufman Hall

Description

Title: ProFee Chart Review Specialist

The Organization

We help society's foundational institutions-healthcare and higher education-to achieve their full potential in service to others.

We are our clients' trusted partners in ever-changing times. For more than 30 years, Kaufman Hall has provided independent, objective insights grounded in sound data and analysis to help clients fulfill their missions, achieve their goals, and tackle their toughest problems.

Kaufman Hall provides world-class management consulting in strategic financial planning (a concept we created); performance improvement; partnerships, mergers, and acquisitions; and treasury and capital markets. Kaufman Hall's consulting is supported by a deep foundation of benchmarking and software tools.

At Kaufman Hall, we believe that sustained success is never an accident. It is the result of sound decision making, based on data-driven analysis and disciplined thinking, and guided by the fundamental principles of corporate finance.

The Position

The Claro Healthcare practice is looking for remote CDI Clinicians to join our team-based environment and be responsible for conducting CDI ProFee chart reviews as part of our project-based consulting engagements. Specific responsibilities include:

• Reviewing charts to ensure documentation is complete, accurate and reflects the severity of illness and resources used
• Identifying opportunities in the client's documentation that appropriately reflect quality of care and capture appropriate revenue for the complexity of patients treated
• Participating in team-based peer reviews
• Creating, editing and finalizing chart review findings that are shared with our clients
• Participating in multiple engagements
• Participating in limited remote client support activities
• Continuing to learn and grow CDI skills and knowledge

While the primary focus will be on supporting the chart review efforts, other job duties may include building education decks, answering clinical questions, doing research or on rare occasions mentoring or teaching our clients.

Qualifications

The ideal candidate will possess:

• Clinical credential RN or MD (open to LPN or Coders if they have the right level of experience)
• 3+ years in a healthcare setting with focus on physician-based documentation improvement and related issues is strongly preferred
• CPC (Certified Professional Coder), CRC (Certified Risk Adjustment), or CCS-P (Certified Coding Specialist- Physician Based) is strongly desired
• Experience in larger hospitals, healthcare systems and/or academic hospital settings is desired
• Prior consulting experience preferred
• Understanding and knowledge of clinical documentation improvement for ProFee, specifically the recent changes to the E/M guidelines which now more heavily rely on medical decision making (MDM)
• Experience with HCC reviews/audits and understanding of reporting guidelines
• Demonstrated written and verbal communication skills and the ability to manage and prioritize multiple projects
• Ability to team effectively with people of various disciplines and backgrounds is essential
• Demonstrated ability to work independently, exercise good judgment, and be resourceful
• Experience/knowledge of regulatory compliance issues facing the healthcare industry
• Client travel is not required for this role
• Travel up to 1-2 weeks a year as they would be expected to attend Firm Wide Annual Training in and any IP Clinical team training
• Preference is Eastern, Central or Mountain time zonesmust be available during standard business hours

Applicants for employment must have work authorization that does not now or in the future require sponsorship of a visa for employment authorization in the United States and with Kaufman Hall (i.e., H1-B visa, F-1 visa (OPT), TN visa or any other non-immigrant status).

Education

• BSN, BA, MBA, MA or MS from an accredited college/university is desired

Physical Requirements

• Must be able to perform essential duties satisfactorily with reasonable accommodations
• Work is generally done sitting, talking, hearing and typing. Visual acuity to use a keyboard, prepare and analyze data and figures; transcribing, viewing a computer terminal; extensive reading

Work Environment

• Travel Required: Occasional 0-10%
• The role is remotely based
• Work is regularly performed in a combination of home office and client settings and routinely uses standard office equipment
• It may require the maintenance of a home office and proximity to an airport for work related travel

Kaufman Hall is committed to providing equal opportunity for all employees and applicants. We recruit, hire, train, promote, pay, and administer all employment actions without regard to actual and also perceived or assumed protected group status as defined by law of an individual or that individual's associates or relatives. Our policies and the law prohibit employment discrimination against any employee or applicant on the basis of any legally protected status.