CLINICAL DOCUMENTATION REVIEWER - Full Time
Company: New Bridge
Location: Paramus
Posted on: June 22, 2022
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Job Description:
The CDR is responsible for identifying immediate and ongoing
needs of the patient and planning a course of care which includes
measurable goals with the patient, provider, family, caregivers,
and payers. In addition, the CDR will review medical records to
facilitate the accurate representation of the severity of
illness.Establishes collaborative and effective working
relationships with physicians, nursing, and other staff.Applies
standardized criteria to all admissions to determine the
appropriateness of admission and level of care.Assures the medical
record contains objective data to support admission and level of
care.Initiates a case management plan and discharge planning
activities at time of admission review and updates it based on
patient progress and needs.In consultation with the physician
establishes a targeted discharge date at the time of the admission
review (estimated length of stay (ELOS)). Documents and
communicates this information to the patient, family and care team.
Monitors progress with this plan daily.Uses clinical knowledge and
defined standards of care to proactively identify inappropriate
resource consumption and discusses with attending physician. Refers
appropriate cases to physician advisor for review.Understands third
party payers current contractual agreements. Completes and
communicates admission and concurrent review information to third
party payers. Documents all payer contacts and denials.Identifies
and refers patients for social work assessment and intervention as
needed.Collects variance data at time of occurrence (i.e. avoidable
days, delays) for use by the department and the
organization.Participates in denial management processes.Provides
notice of termination of benefits (TOB) and level of care changes
(LOC) to individual patients/representatives on a timely
basis.Participates in multi-disciplinary rounds on a regularly
scheduled basis.
Keywords: New Bridge, Paterson , CLINICAL DOCUMENTATION REVIEWER - Full Time, Other , Paramus, New Jersey
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