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Responsibilities

The Managed Care Analytics department exists to monitor and improve the financial performance of Kelsey-Seybold’s (KS) product lines and health plans. The MCA Risk Adjustment Clinical Documentation Specialist team is a highly-skilled team of Clinical Documentation Specialist in the outpatient setting providing chart review services and consultation to the KS Executive team as well as to physicians and physician leadership through the Risk Adjustment program which is designed to impact revenue through compliant, accurate and complete diagnosis assessment and medical documentation.

The Clinical Documentation Specialist ensures the accurate and complete assessment of chronic conditions which fall into the HCC model as required by CMS for Medicare Advantage plans or other risk-adjusted methodologies through chart review. The primary functions of this role include:

• Performs complex reviews of patient’s medical documentation, evaluating quality measures, consistency, completeness of documents, and accuracy for severity of illness (SOI)
• Maintain knowledge of HCC documentation updates
• Communicate with physicians for feedback, documentation improvement, and clarification requests
• Serves as a resource for other clinical documentation specialist outpatient team members.

Job Title: Clinical Documentation Specialist Outpatient

Clinic Location: Pearland Administration Office Building

Department: KS Plan Advantage-Risk Adjustment

Job Type: Full Time

Salary Range: $63,107 – $77,938 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)

Qualifications

Education

Required: Associates degree, Clinical documentation program, Clinical licensure program, or equivalent experience

Preferred: Bachelor of Nursing degree or Master of Nursing Program

Experience

Required: 3+ years in clinical documentation or related field with 3+ years in HCC Coding

Preferred: N/A

License(s)

Required: Certified Risk Adjustment Coder (CRC) or Certified Documentation Education Outpatient (CDEO

Preferred: LVN, RN, RHIT, RHIA

Special Skills

Required:

• Attention to detail
• Excellent problem solving, written and verbal communication skills
• Strong time management skills
• Ability to shift between tasks without losing productivity

Experience with EPIC EMR

Preferred:

• Experience in multi-specialty setting
• Proficient in Word, Excel and Outlook

Other

Required: Ability to travel regionally up to 25%

Preferred: N/A

Working Environment: Office

About Us

Start your career journey and become a part of a community of renowned Healthcare professionals. Kelsey-Seybold Clinic is Houston’s fastest growing, multispecialty organization with more than 40 premier locations and over 65 specialties. Our clinics are comprised of more than 600 physicians and as we continue to grow, our focus is providing quality patient care by adding to our team of clinical and non-clinical professionals that work together in a convenient, coordinated, and collaborative manner. Enjoy the rewards of a successful career while maintaining a work/life balance by joining our team today and changing the way health cares.

Why Kelsey-Seybold Clinic?

• Medical, Vision, and Dental
• Tuition Reimbursement
• Company Matching 401K
• Employee Reward and Recognition Program
• Paid time off for vacation, sick, and holidays
• Employee Assistance Program
• Continuing Medical Education allowance