Remote RN – Clinical Documentation Nurse – Pennsylvania

Tandigm Health, a transformational leader in population health management, is looking for an RN – Clinical Documentation Nurse in the greater Philadelphia area.  We offer a competitive compensation and benefits package and are proud to share a culture of diversity and inclusion.

Primary Duties and Responsibilities: 

 ESSENTIAL FUNCTIONS:

Tandigm Health is looking for a Clinical Documentation Nurse – RN (Accurate Coding and Education Chart Reviewer), Local, Remote who will perform thorough chart reviews to inform providers of potential inferred, embedded, and missing diagnoses not previously identified. In this role, you will be a team player and excellent communicator, who works closely with practices to review medical records to ensure continued high standards in documentation and coding. You will have experience using the CMS/RAF model, coding guidelines, and knowledge of ICD-10 guidelines and are a seasoned nurse with at least 5 years of general clinical experience and clinical chart/claims review experience. You will be a valued member of our local Philadelphia, PA Clinical Team, licensed in the State of Pennsylvania, working together to improve healthcare outcomes. This is a remote position, based in the suburban Philadelphia, PA five county region.

• Consistently exhibits behavior and communication skills that demonstrate Tandigm’s commitment to superior customer service, including quality, care and concern with each and every internal and external customer.
• Obtains access and reviews all Medicare Advantage charts assigned, both remotely and onsite at Physician practices.
• Reviews all portions of the medical records including but not limited to problem lists, past medical and surgical history, medication lists, specialty and primary care notes, imaging, hospital records, labs and vital signs.
• Documents newly found diagnoses and/or screenings and reports out to practices as needed.
• Brings clinical questions to the ACE Medical Director as needed.
• Provides in-person debriefings to the practices and internally using all required reports including newly suggested chart review diagnoses.  Records debriefing comments/ feedback for ACE team
• Recommends ongoing chart review process to ensure continued high standards in documentation and coding.
• Attends and participates as requested in regional and corporate meetings that pertain to ACE coding and documentation.
• Attends courses as needed to improve knowledge of accurate coding and documentation.
• Uses, protects, and discloses Tandigm’s patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
• Performs additional duties as assigned

Required Qualifications:

REQUIREMENTS

• Bachelor’s Degree in Nursing required (8 or more years of additional experience beyond the required years of experience may be substituted in lieu of a degree)
• Current, active, and unrestricted Pennsylvania Registered Nurse Licensure
• 5 years of General Clinical experience required
• Two years of clinical chart or claims review experience with strong attention to detail
• Knowledge of CMS/RAF model, coding band guidelines along with ICD-10 guidelines
• Knowledge of health plan and regulatory requirements.
• Strong technical skills including computer and software skills such as Microsoft Word, Excel, and Outlook
• Experience with at least one EMR and chart abstraction tool

Preferred

• Additional Quality Assurance auditing experience
• Additional Chart Review experience
• Additional Clinical Documentation Improvement experience
• CPC/CRC certification

ESSENTIAL TECHNICAL/INTERPERSONAL SKILLS/OTHER

• Embraces and exemplifies core values of Tandigm Health
• Ability to anticipate and analyze factors
• Strong oral and written communication skills
• Possesses leadership qualities, such as:  Ability to mentor, counsel, coach, teach; Ability to hold providers accountable & educate same on new methods and practices; Ability to listen; Able to resolve conflict; Ability to accept input from others; Ability to give clear direction and provide feedback; Ability to accept coaching from other.
• Able to develop effective strategies for implementation of improved coding and documentation practices.
• Values team members and a strong team player
• Possesses high ethical standards
• Ability to work independently

Applicants must be authorized to work in the US; work visa sponsorship will not be provided.

Equal Employment Opportunities (EEO):
Tandigm provides Equal Employment Opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, sexual orientation, protected veteran status, disability, or genetics.

Search Firm Representatives Please Read Carefully:
Tandigm Health, LLC does not accept unsolicited assistance from search firms for employment opportunities. All CVs/resumes submitted by search firms to any employee at our company without a valid written search agreement in place for this position will be deemed the sole property of our company. No fee will be paid in the event a candidate is hired by our company as a result of an agency referral where no pre-existing agreement is in place. Where agency agreements are in place, introductions are position specific. Please, no phone calls or emails.