Clinical Review Specialist
Mass General Brigham
full-time
Posted on:
Location Type: Remote
Location: Massachusetts • United States
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Salary
💰 $62,400 - $90,750 per year
About the role
- Facilitate the accurate and appropriate identification of patient medical conditions through comprehensive chart review
- Utilize both clinical and coding knowledge of Hierarchical Condition Categories (HCCs) to inform accurate diagnosis considerations
- Educate providers and the clinical care team on all aspects of risk capture and linkages with quality
- Drive Clinical Delivery by performing accurate and timely pre-visit review
- Communicate appropriately with physician or care team to improve medical record documentation
Requirements
- Minimum three (3) - five (5) years’ experience required in either, case management, outpatient coding, utilization review, CDI or other disciplines
- 2 years’ experience in Primary Care, medical coding, risk adjustment or CDI preferred
- Current certification in Clinical Documentation Improvement (CDIP, CCDS, CCDS-O or CDEO) preferred
- Certification in medical coding and or risk adjustment (i.e., CRC, CPC, CCS, CDEO, or CCS-P or other pertinent to outpatient) preferred
- Medical licensure (RN, PA, NP) preferred
- Bachelor’s degree healthcare related preferred
- Strong PC skills / Microsoft applications, including Outlook, Teams, Excel, PowerPoint
Benefits
- Competitive base pay
- Comprehensive benefits
- Career advancement opportunities
- Differentials, premiums and bonuses as applicable
- Recognition programs designed to celebrate your contributions and support your professional growth
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
medical codingrisk adjustmentclinical documentation improvementcase managementutilization reviewHCC codingchart reviewdiagnosis considerationspre-visit review
Soft skills
communicationeducationcollaborationaccuracytimeliness
Certifications
CDIPCCDSCCDS-OCDEOCRCCPCCCSCCS-P