At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. MemorialCare stands for excellence in Healthcare. Across our family of medical centers and physician groups, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork.
This position will provide clinical expertise and education to physicians and physician staff for the HCC risk adjustment program. The Clinical Educator will develop tools and reports which assist physicians in improving documentation compliance and quality. Further, this position identifies strategies and workflow improvements which assist the organization in meeting our Risk Adjustment reimbursement goals.
Essential Functions Include: * Thorough understanding of ICD codes used for risk adjustment and hierarchical coding implications * Effectively communicates the HCC risk model and the importance of accurate documentation and coding of ICD codes to physicians and office staff * Provides clinical expertise to physicians in regards to various HCC related disease states * Identifies workflow optimization opportunities for physician offices * Analyzes physician coding/documentation data to find opportunities in order to maximize revenue * Provides clinical expertise on specific disease state guidelines to physicians and physician staff * Develops and executes programs to increase accuracy of coding in conjunction with Risk Adjustment Department management * Understands HIPAA guidelines and processes * Ability to work independently with minimal supervision * Performs other duties as requested
MINIMUM POSITION REQUIREMENTS: Education/Licensure: Registered Nurse (RN) with strong clinical background. Experience: At least 2 years of clinical experience. Diagnosis coding knowledge preferred. Knowledge: Basic PC skills including Microsoft Word, Excel and PowerPoint. Special Skills/Equipment: Excellent communication skills, both oral and written, are required. MemorialCare Medical Group is a physician-based organization established to provide advanced comprehensive, effective and efficient health care. With over 30 locations from Long Beach to Dana Point, MemorialCare Medical Group includes more than 250 physicians in the areas of internal medicine, family medicine, pediatrics, geriatric medicine, cardiology, cardio thoracic surgery, gastroenterology, neurology, pulmonology, psychiatry, psychology, rheumatology, sleep medicine and therapeutic acupuncture.In addition to multiple locations throughout Orange County, MemorialCare Medical Group offers Urgent Care Centers that are open 365 days-a-year, Telephone Advice Nurses available 24 hours-a-day, 7 days-a-week; and lab and digital X-ray services available on-site at most locations.