Clinical Documentation Quality Coordinator

BJC HealthCare; St. Louis (MO); Remote; USD 85,000 - 115,000; Full time

Benefits offered by this job

Health Insurance

401(k) match

Tuition Assistance

Paid Time Off

Job summary

BJC HealthCare is seeking a Clinical Documentation Quality Coordinator to perform second-level reviews, address mortalities, prebill checks, and staff education. The role requires 2 years CDI and nursing experience, RN licensure, and CCDS certification. This is a remote position serving the Missouri region.

Ideal candidates have ER/ICU exposure, strong knowledge of MS-DRG and ICD-10 guidelines, and the ability to educate CDI staff and medical providers across the enterprise.

Qualifications

• RN with CCDS certification required.
• 2+ years CDI experience preferred and nursing background (ER/ICU highly preferred).
• Understanding of MS-DRG, CCs/MCCs, ICD-10 guidelines and documentation improvement.

Responsibilities

• Reviews clinical documentation to ensure accurate representation of illness severity, mortality risk, and complexity of care.
• Performs retrospective reviews for DRG verification according to CMS/OIG guidance; identifies patterns and opportunities.
• Leads provider engagement and establishes standards for enterprise CDI and documentation improvement across the system.
• Analyzes data trends and CDI performance; educates staff and medical providers on hospital/enterprise level trends.
• Leads education initiatives and enterprise CDI projects across service lines and hospitals.

Skills

Clinical Documentation Improvement (CD

Nursing

RN

Education

Bachelor's Degree

Nursing

Master's Degree

Job description

Additional Information About the Role

BJC is hiring for a Clinical Documentation Quality Coordinator. This role is responsible for 2nd level reviews, mortalities, prebill, mismatches, staff education and other duties as assigned. We are looking for 2 yrs in CDI and nursing exp (er and icu is highly preferred, med surg, etc). Must be RN and CCDS certified. This is a remote position.

Overview

BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.

BJC is the largest provider of charity care, unreimbursed care and community benefits in the state of Missouri. BJC and its hospitals and health service organizations provide $785.9 million annually in community benefit. That includes $410.6 million in charity care and other financial assistance to patients to ensure medical care regardless of their ability to pay. In addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development.

BJC’s patients have access to the latest advances in medical science and technology through a formal affiliation between Barnes-Jewish Hospital and St. Louis Children’s Hospital with the renowned Washington University School of Medicine, which consistently ranks among the top medical schools in the country.

Preferred Qualifications

The Documentation Quality Coordinator (DQC) works at the enterprise level and uses their extensive Clinical Documentation Improvement (CDI) experience to perform second level reviews of complex clinical cases and focused reviews of target case populations prior to final coding and billing across BJC. This position responds to review requests from across the system and escalates unanswered queries to Physician Champions. This position also analyzes data & reports and educates facility-based CDI staff and medical providers on hospital/enterprise level trends and areas of opportunity.

Responsibilities

• Reviews clinical documentation to facilitate the accurate representation of the severity of illness, expected risk of mortality, and complexity of care by improving the quality of the physician’s clinical documentation; performs retrospective reviews for DRG verification according to the OIG (Office of Inspector General) workplan and Centers for Medicare and Medicaid Services (CMS), noting organizational trends or patterns.
• Demonstrates a thorough understanding of the MS-DRG system, CCs/MCCs, impact on quality, and CMI as well as ICD-10 coding systems and the guidelines related to clinical documentation improvement; serves as a resource for the clinical documentation improvement specialist team.
• Leads provider engagement, establishes standards, relationships and maintenance for shared accountability related to enterprise CDI and documentation improvement efforts, with all providers across the enterprise.
• Identifies enterprise trends, variances, deficiencies, and problems utilizing aggregated data and information as part of the integrated clinical documentation improvement program; performs provider and group level CDI data trend analysis, issue identification and solution proposal to leadership.
• Leads and manages ongoing documentation improvement initiatives across service lines and across hospitals including formal and informal education plans related to clinical documentation improvement; leads enterprise functional teams for education, standard queries, standard process & technology, analytics, etc.; acts as a consultant to quality managers, management team, medical staff and health care staff regarding core measure performance and clinical documentation opportunities; leads and/or participates in hospital(s) and organization projects related to documentation improvement; coordinates and collaborates with enterprise CDI for standards in content, process, and technologies.

Minimum Requirements

Education

• Bachelor's Degree
• - Nursing

Experience

• 5-10 years

Licenses & Certifications

• Cert Clinical Documentation
• RN

Preferred Requirements

Education

• Master's Degree
• - Nursing

Supervisor Experience

• No Experience

Licenses & Certifications

• Certified Coding Spec
• Cert Doc Improve Practitioner
• Certified Rev Cycle Rep

Benefits and Legal Statement

BJC Total Rewards

At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.

• Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
• Disability insurance* paid for by BJC
• Annual 4% BJC Automatic Retirement Contribution
• 401(k) plan with BJC match
• Tuition Assistance available on first day
• BJC Institute for Learning and Development
• Health Care and Dependent Care Flexible Spending Accounts
• Paid Time Off benefit combines vacation, sick days, holidays and personal time
• Adoption assistance

To learn more, go to our Benefits Summary.

*Not all benefits apply to all jobs

The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer