Clinical Documentation Second Level Reviewer I Orlando, FL

All the benefits and perks you need for you and your family:

• Benefits from Day One

• Paid Days Off from Day One

• Career Development

• Whole Person Wellbeing Resources

• Mental Health Resources and Support

Schedule: Full Time - Virtual

Shift : Days - Flexible Shift

The role you'll contribute:

Under general supervision of the Director of Clinical Documentation Integrity and in some situations the supervision of the Clinical Documentation Integrity Manager, and in collaboration with physicians, nursing and HIM coders, the Second Level Reviewer I strategically facilitates and obtains appropriate and quality physician documentation for any clinical conditions or procedures to support the appropriate severity of illness, expected risk of mortality, and complexity of care of the patient. The Second Level Reviewer I educates members of the patient care team regarding documentation guidelines, including physicians, allied health practitioners, nursing, and care management. The Second Level Reviewer I adheres to strict departmental and organizational goals, objectives, standards of performance and policies and procedures, continually ensuring quality documentation and regulatory compliance. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.

The value you'll bring to the team:

• Reviews concurrent medical record for documentation compliance including completeness and accuracy for severity of illness (SOI), risk of mortality (ROM), and quality.

• Completes accurate and timely record review to ensure the integrity of documentation compliance.

• Completes accurate and concise input of data into CDI Software resulting in accurate metrics

• obtained through the reconciliation process. Understands and supports CDI documentation strategies (upon completion of didactic training) and continues to educate self and team members, by attending monthly mandated education sessions and using educational tools, videos and provided Webinars

Qualifications

The expertise and experiences you'll need to succeed :

• Five years acute care nursing experience with specific medical/surgical, Intensive Care, post-acute care unit, or Emergency Department experience.

• BSN and 3 years of Clinical Documentation Specialist experience OR

• 4 years of recent Clinical Documentation Specialist experience OR

• Less than 2 years of Clinical Documentation Integrity experience and 10 years of acute care nursing experience

• Current active State license as a Registered Nurse, Nurse Practitioner, Physicians Assistant or an unlicensed physician who has graduated from a medical school that is listed in the World Directory of Medical Schools (World Directory) as meeting eligibility requirements for its graduates to apply to the Educational Commission for Foreign Medical Graduates (ECFMG) for ECFMG Certification and examination at the time of graduation and

• CCDS (Certified Clinical Documentation Specialist) certification or CDIP (Certified Documentation Improvement Practitioner) certification and 2 years of Clinical Documentation Integrity experience

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Category: Health Information Management

Organization: AdventHealth Orlando

Schedule: Full-time

Shift: 1 - Day

Req ID: 25036946

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.