Clinical Coding & Documentation Educator - Licensed Clinician - Hybrid

Boston Children's Hospital; Boston (MA); On-site; USD 60,000 - 90,000; Full time

Job summary

An established industry player is seeking a Clinical Documentation Integrity Educator to enhance the quality of clinical documentation. This role involves leading education initiatives, collaborating with healthcare professionals, and ensuring accurate coding practices. The ideal candidate will have a strong clinical background and coding expertise, contributing to the overall improvement of patient care documentation. Join a diverse team committed to making a difference in healthcare while enjoying a hybrid work environment that fosters growth and innovation.

Qualifications

• Minimum 3 years recent clinical experience in inpatient and outpatient settings.
• Experience with CPT and ICD coding required.

Responsibilities

• Lead education efforts for clinical documentation integrity in the Pediatrics department.
• Collaborate with physicians and coding staff to ensure accurate documentation.

Skills

CPT coding certification

ICD coding knowledge

Clinical experience

Chart review

Communication skills

Education

Bachelor's degree

Licensed Clinician (LPN, RN, PT, OT, Speech-Language, Pharmacist)

Tools

Software systems for data collection

Job description

Job Posting Description

At Boston Children's Hospital, the quality of our care - and our inclusive hospital working environment - lies in the diversity of our people. With patients from local communities and 160 countries around the world, we're committed to reflecting the spectrum of their cultures, while opening doors of opportunity for our team. Here, different talents pursue common goals. Voices are heard and ideas are shared. Join us, and discover how your unique contributions can change lives. Yours included.

The Clinical Documentation Integrity Educator is responsible for:

• Serving as the lead for internal staff education in this new role for the Department of Pediatrics, develop prescriber education as well as execute trend analysis to support department initiatives, and facilitating the improvement in the overall quality and completeness of provider-based clinical documentation to ensure that level of services and acuity is accurately reflected in the medical record.

• Supporting appropriate clinical documentation through extensive interaction with physicians, nursing staff, other patient caregivers, and external coding company to ensure that appropriate reimbursement is received for the level of services rendered to patients and the clinical information utilized in profiling and reporting is complete and accurate.
• Developing and delivering coding education programs for providers, staff, and new hires.
• Ensuring that all clinical treatment, decisions, and diagnoses documented, and coding accurately reflect the patient care.
• Providing orientation on coding, audit processes, and documentation standards.
• Answering coding and compliance questions from providers and staff.
• Serving as a resource for physicians to help link ICD10-CM coding guidelines and medical technology to improve accuracy of final code assignment.
• Querying physicians on a concurrent basis and utilizing software systems to collect, track, and report outcomes.
• Maintaining integrity of data collection.
• Collaborating with external coding staff to promote complete and accurate clinical documentation and correct negative trends. Leading advanced project-based work on topics to advance documentation initiatives in clinical practice.
• Participating in department and organizational projects related to clinical documentation
• Serving as the primary contact for staff workflows and education, including managing orientations, updating training materials, conducting audits, and monitoring industry practices and ICD code updates. Initiates and performs documentation review of selected records to clarify conditions/diagnoses and procedures where inadequate or conflicting documentation exists.
• Analyzing clinical information to identify areas within the chart for potential gaps in physician documentation.
• Collaborating with hospital compliance and Share Service Center - Coding and billing to manage clinical validation denials.
• Collaborating on appeal processes and assessing trends to support proactive improvements. Creating and implementing training and development programs for prescribers to address documentation.
• Helping to identify trends, variances, deficiencies, and problems utilizing data to support proposals to leadership and target education efforts.
• Working 40 hours, Monday-Friday. Hybrid/remote approximately 2-3 days per week on site, requiring flexibility depending on needs.

The Clinical Documentation Integrity Educator must have:

• Licensed Clinician including LPN, RN, PT, OT, Speech-Language, Pharmacist.
• Bachelor's degree or equivalent level or work experience.
• CPT coding certification required or willingness to become certified within 6 months of hire)
• Minimum of 3 years recent, broad-based clinical experience required, experience in both inpatient and outpatient settings preferred.
• 2 years of clinical chart review experience applying ICD coding knowledge to medical record review

Boston Children's Hospital requires all employees to be vaccinated against COVID-19 and Flu, (unless you are eligible for a medical or religious exemption).

Boston Children's Hospital is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status or disability.