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Mass General Brigham

Mass General Brigham connects a full spectrum of care across a system of academic medical centers, specialty and community hospitals, physician networks, a heal

Clinical Review Specialist

Medical ReviewerMedical ReviewerFull TimeRemoteSeniorCompany Site

Location

Massachusetts

Posted

61 days ago

Salary

$62.4K - $90.8K / year

Seniority

Senior

Bachelor Degree3 yrs expExperience acceptedEnglish

Job Description

• 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

Job 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

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