St. Charles Health System

Medical writer

• Provides clinical based review and analysis of the documentation in the patient’s medical record
• Supports accurate capture of patient’s complexity and severity of illness
• Utilizes queries of medical staff and other caregivers to clarify and support completeness of documentation
• Collaborates with physician, mid-level providers, and medical records coders to identify principal and secondary diagnoses
• Conducts initial and ongoing concurrent and some retrospective reviews for system wide admissions
• Initiates tracking process and documents findings on EHR tracking system
• Communicates with providers to capture accurate documentation of patient’s severity of illness

Clinical Documentation Specialist – Level 3

Data Analyst

• Applies analytics to support SCHS strategic priorities and drive Quality System Key Performance Indicators (KPIs).
• Supports data analysis, goal and target setting, and KPI performance improvement.
• Sourcing, compiling, analyzing, and validating quality data.
• Preparing internal and external reports.
• Providing technical support and oversight for routine statistical reporting and ad hoc analyses as directed by the Quality Manager.
• Collaborates closely with teams including Caregiver Safety, Regulatory, Infection Prevention, Business Intelligence, Epic and Clinical Informatics, Finance, Lean Improvement, HRIS, Clinical Documentation Integrity, Patient Safety & Risk, Patient Experience, and Medical Staff.

Quality Data Analyst

Medical Billing and Coding

• Responsible for coding and charging SCMG Clinical Services
• Resolving billing edits and denials
• Advanced skills in reading and interpreting documents contained in the medical record
• Identify and code all relevant ICD–10-CM diagnoses and CPT-4 procedures
• Use available tools to check entries for accuracy
• Reconcile CCI and Medical Necessity edits
• Maintain productivity and quality standards

HIM Coding Specialist, Level 2

• Responsible for coding and charging SCMG Clinical Services as well as resolving billing edits and denials
• Advanced skills in reading and interpreting documents contained in the medical record to identify and code all relevant ICD–10-CM diagnoses and CPT-4 procedures
• Abstracts medical record information in compliance with CMS requirements and SCHS abstracting procedures as appropriate
• Use available tools to check entries for accuracy
• Reconciles CCI and Medical Necessity edits

HIM PB Coding Specialist, Level 2

Insurance

• Work with intermediate payer denials and understand reimbursement methodologies
• Identify denial trends and possible solutions
• Assist other caregivers with level one follow-up tasks
• Resolve denials by researching, appealing, correcting and rebilling claims
• Coordinate with Cash Management to obtain and post payments
• Maintain accurate records in the EHR and provide documentation
• Collaborate with internal and external stakeholders to resolve issues

Insurance Follow-Up Specialist

Manager

• The Regional Clinic Manager (RCM) leads and optimizes clinics within St. Charles Whole Person Care.
• This role focuses on the implementation and expansion of key initiatives, ensuring operational efficiency, financial management, and high-quality patient care.
• Responsible for recruitment, hiring, orientation, discipline, and evaluation of all clinic employees.
• Maintains adequate staffing levels for clinic size and practice type, and coordinates coverage during staffing absences as necessary.
• Implements and manages all organizational safety directives and goals.
• Assists the Administrative Director (Primary Care, Population Health or Specialty Services) with the implementation of marketing and strategic planning for the clinic(s) and any other duties related to the successful management of the practice(s).