RN, Clinical Documentation Improvement Specialist

Central Maine Healthcare is seeking a Full Time, RN, Clinical Documentation Improvement Specialist to join our team!

Central Maine Healthcare is an integrated healthcare delivery system serving 400,000 people living in central, western and Midcoast Maine. CMH's hospital facilities include Central Maine Medical Center in Lewiston, Bridgton Hospital and Rumford Hospital. CMH also supports Central Maine Medical Group, a primary and specialty care practice organization. Other system services include the Central Maine Heart and Vascular Institute, a regional trauma program, LifeFlight of Maine's southern Maine base, the Central Maine Comprehensive Cancer Center and other high-quality clinical services.

If you are passionate about making a difference and are looking for your next great career opportunity, we look forward to reviewing your application!

The Clinical Documentation Improvement Specialist will facilitate improved quality, accuracy and completeness of medical record documentation and quality gap closure by conducting proactive reviews of patients’ electronic medical records and other data sources. This review will occur in advance of scheduled patient office visits to ensure all gaps in care are identified and addressed by the provider during that visit. In addition, this role may perform audits and medical charts reviews. All duties will be performed in accordance with ICD-10 coding guidelines, internal protocols, and CMS guidance.

• Associates’ degree in Nursing or higher required; Bachelor’s Degree in Nursing Preferred
• Current RN license in good standing required
• Recent clinical experience (minimum 5 years), preferably in primary care setting
• Experience with EMR, preferably Cerner
• Certified Risk Adjustment Coder or Certified Professional Coder through AAPC or CDI or CCS certification through AHIMA, or ability to obtain certification within 6 months from date of hire
• 1+ years recent experience ICD-10 coding with strong attention to detail and high accuracy rate preferred
• 1+ years of recent Risk Adjustment / HCC Coding experience preferred

Knowledge, Skills and Abilities:

• Proficient with Microsoft Office products (Word, Outlook, Excel, PowerPoint)
• Working knowledge of health plan/insurance terminology and concepts
• Excellent professional judgment and decision-making ability
• Flexibility and willingness to work both independently as and as a team member in a developing program
• Strong organizational and prioritization skills
• Excellent oral and written communication skills adaptable to individuals with varied levels of understanding at all levels of the organization
• Highly developed problem solving and deductive reasoning skills
• Dependable, self-directed, and diplomatic
• Able to participate collaboratively with all members of the care team
• Knowledge of HEDIS, abstraction concepts, Medicare Risk Adjustment and CMS risk adjustment guidelines preferred
• Must meet deadlines and produce accurate work product
• Must be able to handle multiple tasks at the same time and work well independently

CMH actively promotes diversity in its workforce at all levels of the organization. We strive to create and maintain a setting where we celebrate cultural and other differences and consider them strengths of the organization. CMH is an equal opportunity workforce and no one shall discriminate against any individual with regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, genetic information or veteran status with respect to any offer, or term or condition, of employment. We make reasonable accommodations to the known physical and mental limitations of qualified individuals with disabilities.