Clinical Documentation Nurse - RN

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. 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