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Chart Review Coordinator

Primary Duties and Responsibilities: 

SUMMARY: 
Tandigm’s Accurate Coding & Education (ACE) Chart Review team helps Tandigm’s network of PCPs improve the comprehensiveness of medical care by identifying complex clinical insights, which physicians then utilize at point of care.  The ACE Chart Review Coordinator will assist in the Chart Review team’s programs, across multiple payors and networks.  Routine duties will include reviewing medical records, verifying clinical data, and participating in QI activities, both internally and with the Tandigm Value Partners practices..  The ACE Chart Review coordinator will also collaborate cross-departmentally within Tandigm while also routinely working with network practice stakeholders, including both administrative staff and clinicians.

Essential Functions

  • 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.
  • Participates in quality control and quality assurance activities.
  • Obtains access and reviews all charts assigned remotely from Physician practices.
  • Reviews 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 as assigned.
  • Brings clinical questions to the Chart Review Team Lead and/or ACE Medical Director as needed.
  • Attends and participates as requested in corporate meetings as well as those that pertain to ACE coding and documentation. 
  • Attends courses as needed to improve knowledge of accurate coding and documentation. 
  • Performs administrative functions to support the overall effectiveness of the ACE team
  • Documents interactions accurately and with great attention to detail, utilizing applicable platforms and Excel proficiently.
  • Develop familiarity with clinical and medical terminology pertinent to the patient population.
  • 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

Education, Experience and Skills

POSITION REQUIREMENTS: Education, experience and skills
Minimum
  • Current, active, and unrestricted Pennsylvania Licensed Practical Nurse or Registered Nurse Licensure
  • Minimum of five years of General Clinical experience required.
  • Strong technical skills including computer and software skills such as Microsoft Word, Excel, and Outlook.
  • Experience with at least one EMR. 
Preferred
  • Additional Quality Assurance auditing experience. 
  • Two years of clinical chart or claims review experience with strong attention to detail.
  • Knowledge of health plan and regulatory requirements.
  • Knowledge of CMS /RAF model, coding and guidelines along with ICD-10 guidelines.

Essential Technical/Motor/Interpersonal Skills/Other

  • Embraces and exemplifies core values of Tandigm Health.
  • Self-motivated and proactive; responds to requests in a timely and efficient manner.
  • Strong oral and written communication skills.
  • Possesses qualities, such as: 
  • Ability to listen
  • Ability to accept input from others
  • Ability to give clear direction and provide feedback
  • Ability to accept coaching from others 
  • Values team members and a strong team player.
  • Possesses high ethical standards.
  • Ability to work independently.
  • Collaborative and resourceful; functions successfully in a team environment as well as independently.
  • Ability to travel to sites within the region as needed


Our company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics.

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