The Clinical Documentation Specialist works independently and is responsible for performing clinical chart reviews and pre-charting on the Medicare advantage (MA) patient population. The Clinical Documentation Specialist exercises critical thinking by applying clinical knowledge to correlate relevant diagnosis for the primary care physician (PCP) to consider at the time of the face to face visit. The Clinical Documentation Specialist will also be responsible for tracking and verifying all their findings onto the Hierarchical Condition Category (HCC) Tracker.
- Reviews and assesses medical charts clinically by suggesting HCC diagnosis to the PCP for consideration in reflecting the true burden of illness on the MA population.
- Supports a variety of projects as needed when reviewing related medical records for Providers with high volume MA patients and low RAF scores.
- Extracts and organizes data to complete the High-Risk patient evaluation to submit to the health plans.
- Conducts pre-charting findings and orders prior to patient visit with PCP daily/weekly.
- Reviews PCP's HCC documentation & coding to reflect the true acuity of the patient.
- Plans and coordinates weekly MA appointments of Medicare Advantage charts based on schedules.
- Organizes and compiles findings onto HCC Tracker daily.
- Collaborates to problem solve and make decisions to achieve desired outcomes
- Responds timely, effectively and appropriately to deliverables
- Identifies and responds appropriately to both internal and external customer needs utilizing available resources
- Shares knowledge, time and expertise to assist other members of the team
Providing healthcare for more than 100 years, Cedars-Sinai has evolved into one of the most dynamic and highly renowned medical centers in the world. Along with caring for patients, Cedars-Sinai is a hub for biomedical research and a training center for future physicians and other healthcare professionals. This attracts exceptional talent to Cedars-Sinai, including world-renowned physician-scientists who seek a place where they can both conduct research and see patients--the ideal formula for discovery and its translation into cures. Our patients benefit from access to doctors at the top of their fields, and our researchers have an ideal community in which to study the impact of healthcare challenges, and reflect that knowledge in their research. The greater Los Angeles area in which Cedars-Sinai resides possesses unparalleled cultural and ethnic diversity which offers outstanding opportunities for translational and clinical research... and a dynamic environment for medical education.Although community based, Cedars-Sinai is a major teaching hospital affiliated with the David Geffen School of Medicine at the University of California, Los Angeles (UCLA). Cedars-Sinai has highly competitive graduate medical education programs in more than 50 specialty and subspecialty areas, a graduate program in biomedical sciences and translational medicine, a clinical scholars program directed towards junior physicians with aspirations to become clinical scientists, and post graduate training opportunities.There are more than 250 full-time faculty members at Cedars-Sinai. The voluntary medical staff, comprised of more than 2,200 specialty board-certified or board-qualified physicians, represent all of the specialties and subspecialties and collaborate with full-time medical staff in the teaching responsibilities of the graduate medical education programs.