The Clinical Advocate is the liaison between Change Healthcare Philippines Inc. and the clinical reviewers for the direct purpose of collecting information, solving problems, answering questions and providing support in relation to work performance and documenting pertinent information within the appropriate database. The clinical advocates coordinate the assignment of
workload across Clinical Readers and manages intraday productivity of assigned staff. This role collaborates with cross-functional department leads and key stakeholders to identify work execution strategy and executes work assignment in line with the agreed plan and priorities of the Department. The Clinical Advocate will also assist the Sr. Manager of Clinical Operations in
overseeing the implementation and delivery of key operations initiatives in the Manila site. Position will translate business requirements into effective operations procedures that in line with the department’s business objectives.
SUMMARY OF DUTIES & RESPONSIBILITIES
ESSENTIAL RESPonSIBILITIES include the following. Other work-related duties may be assigned.
1. Productivity
Respo
nsible for mo
nitoring assignments and assuring full use of nurse/coder capacity.Respo
nsible for mo
nitoring exception reports per employee.Respo
nsible for fielding any system issues within 1 hour of notification.Daily and intraday review of projects and chart inventory to maintain efficient assignments;Assign charts inventory to each Clinical Reader ensuring that chart assignmentstrategy is aligned with department’s goals. This includes adjusting current assignments to balance the load for logical and efficient use of Clinical Reader inventory;Add to existing assignments of Clinical Readers so that all provider sites are assigned;Reassign charts of clinical readers as necessary;Mo
nitor and analyze daily and intraday performance;Report out daily and intraday Clinical Reader production performance.Code risk adjustment charts utilizing ICD-10 codesCode a minimum of one chart daily to maintain ICD-10 coding skills, in addition to dentifying any trends or challenges within CAO.Code charts for risk adjustment when requested by manager due to down time or to assist with chart production.
2. Communication
Respo
nsible for sending Welcome Packet to their assigned clinical employees.Respo
nsible for daily communications with their assigned clinical employees.Reviews any special requests or scheduling changes.Respo
nsible for delivery of any communication from management to their assigned clinical employees.
3. Other
Completing data entry assignments as needed.Scheduling as needed.Assist with development and updat
es of training materials as needed.Training other staff members within CHPI on all clinical related systems located in iTools™ and Clinical Auditing Portal.Maintain regular and effective communications with management to allow management to make informed decisions on staffing and chart inventory needs;Participate in meetings related to these duties, as required;May be assigned other projects, duties and respo
nsibilities as required.Assist with management and tracking of PTO and absencesOther assignments as deemed necessary by Change Healthcare Philippines Inc.
In addition to the responsibilities listed above, the job holder may be required to perform other duties as assigned by members of the Operations Leadership Team from time to time.
REQUIRED EDUCATION & EXPERIENCE
High school diploma prefer graduate of any 4-year college courseCoding certification by AAPC and /or AHIMA. CRC, CPC preferredMinimum of 6 mo
nths ICD-10 coding experience helpful
EXPERIENCE
At least (1) year working experience in Change Healthcare Philippines Inc. preferred;Working knowledge of scheduling and workforce management required;With leadership background preferred;Proficiency in Microsoft Word, Outlook and Excel required;Ability to speak effectively to groups of employees.
REQUIRED KNOWLEDGE & SKILLS
Excellent written and oral communication skills;Strong managerial, leadership, and interperso
nal skills;Outstanding organizatio
nal skills;Exceptio
nal customer service and co
nflict resolution skills;Ability to work effectively in a team environment;Flexibility in work schedule to meet departmental needs.ICD-10 Coding Guidelines and Risk Adjustment Coding