Clinical Documentation Improvement Specialist

24 hours ago

Chennai, Tamil Nadu, India beBeeClinical Full time ₹ 9,00,000 - ₹ 10,95,000
Clinical Documentation Improvement Specialist

We are seeking an experienced Clinical Documentation Improvement Specialist to oversee all aspects of charge creation and capture, ensuring accurate and compliant billing practices.

  • Charge Creation and Capture Oversight:
    • Oversee the process of charge creation, ensuring accurate and timely capture of all billable services.
    • Review encounter documentation to verify that charges are supported and appropriately coded.
    • Identify and correct any errors or omissions in charge capture.
    • Monitor charge lag and implement strategies to reduce delays in billing.
    • Ensure that all charges are compliant with coding guidelines (CPT, HCPCS, ICD-10) and payer regulations.
  • Charge Master Maintenance:
    • Participate in the maintenance and updating of the charge master (CDM), if applicable.
    • Ensure that the CDM is accurate and reflects current coding guidelines and payer requirements.
    • Collaborate with other departments to implement CDM changes.
  • Liaison Activities:
    • Liaise with clinical teams to understand clinical workflows and documentation practices, ensuring accurate charge capture.
    • Collaborate with revenue cycle teams to resolve claim issues and improve overall revenue cycle performance
  • Audits:
    • Conduct regular audits of documentation and billing practices to identify areas for improvement.
    • Develop and implement corrective action plans to address identified deficiencies.
    • Ensure compliance with all applicable coding and billing regulations.
  • Denial Management:
    • Analyze claim denials related to coding or documentation issues.
    • Identify root causes of denials and implement strategies to prevent recurrence.
    • Work with billing and coding staff to appeal denied claims.
  • Reporting and Analysis:
    • Prepare reports on charge capture rates and accuracy.
    • Analyze data to identify trends and patterns in coding and billing practices.
    • Recommend process improvements based on data analysis.
  • Team Leadership and Mentorship:
    • Serve as a mentor and resource for junior claims processing staff.
    • Provide guidance and support to the team on complex coding and billing issues.
    • Assist in training new team members on charge capture procedures.

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