2320 Registered Nurse [Clinical Documentation Integrity]

Company Description

The Department of Public Health prioritizes equitable and inclusive access to quality healthcare for its community and values the importance of diversity in its workforce. All employees at the Department of Public Health work to advance equity, inclusion, and diversity with a specific lens and focus on race, ethnicity, gender, sex, sexuality, disability, and immigration status. 

• Application Opening –  Wednesday, January, 15, 2025
• Application Deadline – Application filing will close on or after Tuesday, February 18, 2025 
• Appointment Type: Permanent Civil Service
• Recruitment ID:  CCT-2320-H00083
• Employment Type: Full-Time 

*This role is in-person at ZSFG Hospital with 8-hour shifts, Monday through Friday*

The Mission of the San Francisco Department of Public Health (SFDPH) is to protect and promote the health of all San Franciscans. SFDPH strives to achieve its mission through the work of multiple divisions - the San Francisco Health Network, Population Health, Behavioral Health Services, and Administration. The San Francisco Health Network is the City’s only complete system of care and has locations throughout the City, including Zuckerberg San Francisco General Hospital and Trauma Center, Laguna Honda Hospital and Rehabilitation Center, and over 15 primary care health centers. The Population Health Division (PHD) provides core public health services for the City and County of San Francisco: health protection, health promotion, disease and injury prevention, and disaster preparedness and response. Behavioral Health Services operates in conjunction with SFHN and provides a range of mental health and substance use treatment services.

Job Description

EXAMPLES OF DUTIES:

• Reviews inpatient medical records for identified payor populations.
• Ensures that clinical documentation reflects the appropriate level of service.
• Utilizes both clinical and coding knowledge effectively.
• Performs initial inpatient chart reviews.
• Manages concurrent medical record reviews.
• Participates regularly in scheduled case management and hospitalist meetings.
• Maintains an up-to-date working DRG and a DRG assignment mismatch report detailing differences.
• Utilizes encoder software to determine the working DRG, performs audits, and communicates daily with HIM coding staff.
• Assists in the development of diagnosis-specific and DRG-specific queries.
• Utilizes documentation improvement communication tools effectively.
• Uses computer-based tools to retrieve and maintain inpatient census data, track coding, and perform audits.
• Resolves inconsistent, conflicting, or ambiguous documentation through the physician query process.
• Follows up with physicians to resolve all queries before the patient's discharge.
• Collaborates with and supports coders.
• Maintains good rapport and cooperative relationships.
• Performs audits to support ongoing monitoring, corrective actions, and improvements within the Clinical Documentation Improvement (CDI) process.
• Collaborates with health information management coding staff, physicians, and financial services. Addresses payment denials, medical necessity issues, and documentation concerns.
• Instructs staff on proper documentation in medical records.
• Reviews inpatient claims with medical necessity denials.
• Maintains detailed Case Mix Index (CMI) reports.
• Fosters respect for privacy by maintaining confidentiality.
• Performs duties in accordance with ethical and legal compliance standards.
• Educates all members of the patient care team on an ongoing basis.
• Actively participates in and supports the Performance Improvement Department.
• Performs other job-related duties as assigned.

Qualifications

MINIMUM QUALIFICATIONS:

LICENSE: Possession of a valid permanent/temporary (including interim permit) California Registered Nurse License (**IMPORTANT: Be sure to include your California RN license number in the application, as failure to do so may result in rejection**);

AND

EXPERIENCE: At least one (1) year of experience working as a Registered Nurse

SPECIALTY REQUIREMENTS:

• Clinical Documentation Specialist (CCDS) certification
• At least 3 years of clinical experience in an acute care setting
• At least 2 years of experience in clinical documentation integrity/improvement in a healthcare setting

One-year fulltime employm