United Spinal Association Jobs

Metro Health (now the University of Michigan Health-West) is looking for a Lead Clinical Document Specialist.

The UMHP Lead Clinical Documentation Specialist is responsible for providing work direction to the UMHP Clinical Documentation Specialist (CDS) team in the planning, coordination and upstream education of clinical documentation improvement and clinical revenue optimization for the ambulatory Primary Care site and Specialty Care service line physicians, APPs and staff. The lead coordinator will provide full program management and improve/optimize workflows and processes to support the education and analysis of coding, documentation, revenue optimization, reimbursement excellence, Annual Wellness Visits (AWVs), modifier usage trends/development, portal messaging and CPT/ICD-10 and HCC code usage for UMHP to achieve best in class in ensuring appropriate payment for outpatient professional clinical visits/services, surgeries, procedures and imaging studies. The lead will partner with the medical site and service line leadership to identify gaps and opportunities for revenue capture and assist with implementation of processes in the ambulatory clinical setting. This position will lead the review and delivery of physician and APP clinical documentation and charge capture, provide updates to leadership on Return-on-Investment status and progress of efforts to improve charge capture and maintain a strong collaborative relationship with the Clinically Integrated Network (CIN) and other relevant departments. The lead coordinator will provide partial coordination and project management of the Medical Group and Population Health governance structure, guiding the coordination and evolution of the UMHP Revenue Oversight Committee (UROC) and UMHP Revenue Implementation Committee (URIC).

Essential Functions and Responsibilities:

Leads the design, implementation, education and evaluation of tools and resources to assist providers with efficient and effective documentation, accurate coding and revenue optimization and charge capture opportunities. All coding edits and/or revisions including claim submission are the sole responsibility of the HIM and billing teams. All coding education will be approved by Compliance prior to implementation.

Provides work direction, monitors progress and regularly evaluates the UMHP Clinical Documentation Specialists (CDS) to ensure effective implementation, prioritization and continued success for all CDS projects.

Provides partial coordination and project management of the Medical Group and Population Health's governance structure Councils, Committees and Offices.

Provides leadership, coaching and mentoring to team members. Provides input for coaching conversations, growth opportunities, hiring and annual increases for the department.

Leads the facilitation and deployment of the UMHP CDS coding and documentation education strategy and collaboration efforts with the OPWB Associate Clinical Leaders (ACLs) of Positive Practice, as needed.

Leads the development of an upstream coding, documentation, charge capture, revenue optimization and reimbursement excellence education approach focused on new departments and emphasizing new specialty areas to increase knowledge and establish sustainable best practices early on.

Leads the onboarding process for new physicians and APPs with orientation to documentation, coding and charge capture excellence, establishing a 3-to-9-month check-in/assessment process with all recently onboarded providers ensuring appropriate charge capture check-ins.

Leads the communication with Primary Care site and Specialty Care service line leaders, physicians and APPs with regard to clinical documentation and medical coding for patient care services. Facilitates CDS interaction with site/service line provider champions.

Tracks ROI and leads the preparation and analyzation