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medical doctor non-clinical - Yonkers, United States - Montefiore Medical Center
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Description
Job Title: MEDICAL DOCTOR NON-CLINICAL
The physician advisor will act as a physician reviewer and liaison between the Clinical Documentation Integrity (CDI), Health Information Management (HIM), Quality and the hospital's medical staff to facilitate accurate and complete documentation. This includes documentation for quality programs, abstracting of clinical data, capture 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.
EDUCATION:
M.D. License to practice Medicine.
5+ years of clincial experience
Knowledge of clinical documentation guidelines and regulatory requirements.
Working knowledge of state and federal regulations regarding fraud and abuse laws.
Experience with electronic health records (EHR).
Applies 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.
Ability to see the big picture of data, recognizing all aspects of coded data and the importance of how it uses, i.e. quality measures, risk adjustment, etc.
Advanced knowledge of researching coding related issues. (i.e. coding clinics, coding guidelines, etc.)
Keeps abreast of coding guidelines, HCC diagnoses, HAC lists, and reimbursement reporting requirements.
Possesses ability to be confidential; demonstrates knowledge of HIPAA Privacy and Security Regulations as evidenced by appropriate handling of sensitive information.
Possesses a cooperative and positive attitude toward management and co-workers by responding politely and professionally and being a valued team player.
Work collaboratively with physicians, nurses, and other healthcare providers to improve documentation practices and ensure accuracy of clinical documentation.