Clinical Documentation Analyst

The Clinical Documentation Analyst is responsible for collaborating with clinicians at established points in time to assure accurate documentation as well as understanding of agency policies, procedures, and standards. The position serves to provide appropriate support and promote quality patient care, positive patient outcomes, and staff retention.

The Clinical Documentation Analyst is also responsible for the investigation, review, monitoring, and tracking of system related errors from various audits, reports and work queues within the agency Electronic Medical Record (EMR). Collaborates with Clinical Operations across all service lines.

Qualified individuals must be capable of performing the following essential duties and responsibilities, with or without reasonable accommodations:

• Responsible for the monitoring and correction of all assigned clinical errors as identified in the agency EMR reports and work queues.
• Collaborates with Clinical Operations (CHHA, Hospice, LHCSA) and PFS on the resolution of clinical documentation issues impacting timely billing.
• Assist in the review of documentation requests from third party payers to respond to claim denials for medical justification including but not limited to Medicare ADR’s and Medicaid Determinations.
• Participates in agency payor change process.
• Responds to and resolves clinical documentation issues resulting in billing inquiries.
• Serves as expert in clinical documentation requirements in all areas of Certified Agency Clinical Documentation/Justification. Completes chart reviews as appropriate or as assigned. Identifies patterns of documentation non-compliance and recommends remediation strategies.
• Collaborate with Education and clinical operations to provide staff training and education on clinical documentation error trending and prevention as assigned.
• Collaborate with education to develop and maintain education related to the following, including, but not limited to mandatories, competencies, and skills labs.
• Collaborate with education and clinical supervisors/managers. Participate in department and team meetings to provide education to staff on best practice, documentation, and regulatory updates.
• Performs comprehensive chart audits as needed to identify performance improvement needs. Develop appropriate education and monitoring to ensure clinical excellence and quality patient care objectives are achieved. Communicates results to managers and partners in follow-up to ensure accountability.
• RN’s to perform drug regimen review per regulatory requirement on all therapy starts of care. Communicates with clinician and management regarding concerns.
• Proficient use of Home Care electronic medical record and Decision Support software. Prepare, distribute and present reports related to utilization of care and clinical outcomes as needed.
• Responsible for the Key Performance Indicators (KPI’s) established by their manager.
• Other duties as assigned.

*Note: The above information for this job has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to this job.

Education & Experience - Applicants must possess the following qualifications or an equivalent combination of education and experience:

• Education: RN, OT, PT, or SLP with at least a bachelor's degree and associated License.
• OASIS Certification, expected within the first year of hire.
• Experience: Minimum two years of Home Health Agency experience and knowledge of documentation standards preferred.

Knowledge, Skill, & Ability Requirements

• Knowledge of Medicare Home Care and Hospice rules and regulations and governing third party payers.
• Excellent interpersonal skills.
• Excellent oral and written communication skills.
• Excellent organizational and analytical skills.
• Positive customer relation skills and the ability to work effectively as a member of interactive teams.

Technical & Systems/Equipment Proficiencies

• Microsoft Office Suite: Outlook, Word, Power Point and Excel
• E-Record (electronic medical record systems)
• Office equipment, such as computers, printers, copiers, and fax machines, as well as multi-line phone systems
• Intranet/Internet

Physical Requirements:  The position involves frequent sitting, standing, and walking. Occasional bending and pushing may be required. Tasks such as kneeling, squatting, reaching, twisting, balancing, climbing, and pulling are required infrequently.

Other

• Valid Driver’s License
• Current Auto Insurance

Job Code:  155

Salary Range:   $67,700 - $117,291

The referenced pay range represents the minimum and maximum compensation for this job family.  Individual annual salaries/hourly rates will be set within the job’s compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.