Schedule: Monday–Friday, First Shift (Central Time)
Systems: 3M 360 and Epic
Medovent Solutions is a nationally recognized healthcare staffing and consulting firm headquartered in Tampa Bay. We are proud to be named one of the Best Places to Work by the Tampa Bay Business Journal, included in the Fast 50 for fastest-growing companies in Tampa Bay, and honored as part of the prestigious Inc. 5000 list of America’s fastest-growing private companies. We are passionate about supporting healthcare organizations and professionals nationwide with expertise, innovation, and integrity.
Position Overview
Medovent Solutions is seeking an experienced Inpatient Concurrent Review Specialist to perform concurrent patient record reviews and promote complete, accurate, and timely clinical documentation. This professional will collaborate with providers, Health Information Management (HIM) coders, Clinical Documentation Improvement (CDI) specialists, and interdisciplinary teams to support accurate Diagnosis Related Group (DRG) assignment, Severity of Illness (SOI), Risk of Mortality (ROM), reimbursement, and data reporting.
Responsibilities
- Review inpatient medical records to determine whether documentation completely and accurately reflects the patient’s conditions, treatment, and need for hospitalization.
- Identify ambiguous, incomplete, missing, or conflicting documentation and submit compliant queries to physicians or other practitioners for clarification.
- Update the working DRG when appropriate.
- Promote documentation of clinical conditions and procedures that supports the appropriate SOI, ROM, and complexity of care.
- Recommend clear, compliant, and proficient provider queries.
- Escalate provider nonresponses or inappropriate responses for reconciliation according to established procedures.
- Collaborate with HIM coders, CDI specialists, and other stakeholders to identify and reconcile documentation and coding opportunities.
- Analyze working DRGs compared with final coded DRGs.
- Work collaboratively with physicians, advanced practice providers, nurses, Patient Safety, Health Care Improvement, and other interdisciplinary teams.
- Validate accurate DRG assignments with appropriate clinical and coding partners.
- Develop or provide ongoing education regarding clinical documentation opportunities to practitioners, HIM coders, CDI specialists, and other stakeholders.
- Educate allied health professionals, administration, Utilization Review, and Comprehensive Care teams about the effects of documentation on SOI, ROM, case mix index, reimbursement, and data reporting.
- Compile, interpret, and analyze data to identify opportunities for improving documentation practices.
- Analyze trends involving DRG impact, SOI, ROM, physician profiles, and related performance measures.
Required Education and Credentials
- Bachelor of Science in Nursing.
- Active Texas RN license or multistate Compact RN license.
- Current Certified Clinical Documentation Specialist or Certified Documentation Improvement Practitioner credential.
Required Experience and Qualifications
- At least four years of nursing experience or a combination of inpatient coding and nursing experience.
- At least two years of Clinical Documentation Improvement experience.
- Alternatively, for candidates with a Health Information Management background, at least four years of medical record review experience involving inpatient coding, auditing, quality, case management, or CDI.
- Strong knowledge of ICD-10 coding principles.
- Thorough understanding of complications and comorbid conditions and their effects on final DRG assignment, SOI, and ROM.
- Experience conducting concurrent inpatient medical record reviews.
- Ability to communicate effectively and collaborate with physicians, coders, clinical teams, and organizational leadership.
- Experience using 3M 360 and Epic.
Remote Work Eligibility
This position is 100% remote; however, candidates cannot be hired from California, Hawaii, New Jersey, New York, North Dakota, Oregon, Puerto Rico, Rhode Island, the U.S. Virgin Islands, Washington, or Wyoming.
Competitive base salary, commission package, aggressive bonus program, and an exceptional benefits package including a comprehensive medical/dental/vision plan, a 401(k) savings plan, paid holidays and vacation pay.
Medovent Solutions is an Equal Opportunity Employer and does not discriminate in its employment practices on the basis of race, religion, sex, color, national origin, age, disability, citizenship, genetic information, veteran status or military service, or any other characteristic protected by federal or Florida law.
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