DRG Clinical Documentation Educator

About this role

Thank you for considering a career at Ensemble!
Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.
Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!
O.N.E Purpose:

• Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.

• Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.

• Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.

The Opportunity:

CAREER OPPORTUNITY OFFERING:

• Bonus Incentives

• Paid Certifications

• Tuition Reimbursement

• Comprehensive Benefits

• Career Advancement

• This position pays between $69,400 to $119,700annually based on experience

TheDRGSenior Coding Educatoracts as a subject matter expert to educate, train, and develop/revise processes in coordination with leadership to assist in achieving CDI’s goal of facilitating accurate and complete documentation for coding and the capture of severity, acuity, and risk of mortality and most accurate Diagnosis Related Group (DRG) assignments.

Job Responsibilities:

• Implements and continuouslydevelopsonboarding for all new Clinical Documentation Specialists (CDSs) for mentoring and education needs. Leads and coordinates training of new CDI staff. Collaborate with CDI leadership and other clinicians tofacilitatethe ongoing relevance of department specific orientation content, educational materials, and training programs/resources.

• Formulates customized education to other healthcare professionals based on audience and areas of opportunity. Audiences include, but are not limited to CDS/Coders, providers, mid-levels, nursing, dietary, Quality, etc. Education provided includes 1:1 education and/or group education. Interacts with medical staff members, directors, and senior hospital leadership staff as needed.

• Makes recommendations for documentation improvement and queries to capture care and intensity of services as supported within the medicalrecorddocumentation.

• Demonstrates understanding of complications, co-morbidities, severity of illness, risk of mortality, case mix index, secondary diagnoses, and the impact of procedures on the final Diagnosis Related Group (DRG).

• Educate members of the CDI teamand providerson thereviewfunctions within the CDI program to meet andmaintainenterprise goals andobjectives, regulatory compliance, policies and procedures and standard operating procedures.Assistwith the development and maintenance of system CDI policies and procedures. Remain current on CDI guidelines and practices.

• Ensuresprogram compliance by following coding guidelines and coding clinics. Remains current with coding information to ensure accuracy of codes assigned based on documentation.

• Serve as a key resource foraccurateand ethical documentation standards and regulatory requirements.

• Demonstrates the ability to draft compliant queries as endorsed by AHIMA and ACDIS.

• Performs medical record reviews for completeness and accuracy in capturing severity of illness, risk ofmortalityand clinical validation.

• Determinesif professionally recognized standards of quality care are met.

• Audits CDSs as needed to ensure that systemobjectivesare met. Develops educational plan for individual CDS based on Quality Audit (QA) outcomes. Provides 1:1 mentoring as needed.

• Oversees and coordinates SMART related education, meetings, and requirements for the department and as instructed by the SMART department.

Experience We Love:

• 3+ yearsrelated experiencewithclinical documentation and/orcoding

• Experience with multiple EMRs (Epic, Meditech and Cerner)

• Detail oriented and self-motivated

• Strong organizational skills

• Excellent speaking and presentation skills

• Working knowledge of Microsoft applications, includingcreationof Power Point presentations.

• Could require minimal travel

• Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences

• This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require.

Minimum Education:

• BachelorsDegreeor Equivalent Experience

Licensure Required:

• MD (Doctor of Medicine)

OR

• RN (Registered Nurse)

CertificationRequired:

Candidates must have and keep current at least one of the following professional certifications (CPC, CPMA or CCS Preferred):

• CCS (Certified Coding Specialist)

• CPC (Certified Professional Coder)

• CPMA (Certified Professional Medical Auditor)

• RHIA (Registered Health Information Administrator)

• RHIT (Registered Health Information Technician)

AND

• Certified Revenue Cycle Representative (CRCR)completion within 9 months of hire

Join an award-winning company
Five-time winner of “Best in KLAS” 2020-2022, 2024-2025
Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024
22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024
Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024
Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020,…