Clinical Documentation improvement Specialist/ Revenue cycle managemen

Igor Pirus MD (IMG), MBA, CCS, CCDS

Phone: 818-***-****

****.*****@*****.***

***** ******* **. #*

Stevenson Ranch CA 91381

Education

**/**** – 08/2021 MBA in Healthcare Management WGU

09/1996 – 06/2004 MD Ivano-Frankivsk National Medical University

Residency and fellowship in oncology hospital (Ukraine)

Work History:

08/2020 – until now CDIS Huntington Hospital (Pasadena, CA) Full time

01/2021 - 09/2021 CDIS Mission Community Hospital (Van Nuys, CA) Part time

12/2018 – 12/2020 CDS, Centinela Hospital Medical Center CDS/CDI

(Inglewood, CA) Per Diem

12/2019 – 12/2020 CDIS, Olympia medical Center, Per Diem

(Los Angeles, CA), Per Diem

08/2015- 11/2018 CDS, Prime Healthcare Inc. CDS/CDI (Ontario, CA)

07/2004 - 03/2015 MD, Radiologist oncologist (Ukraine, UA)

Skills:

Certification: CCS, CCDS

•Completing a review of clinical data from medical records for identified patients in the required timeframe.

•Responsible for improving the overall quality and completeness of clinical documentation.

•Analyzes the status of the patient, current treatment plan, past medical history and identify possible gaps in physician documentation.

•Supports the accuracy and completeness of the clinical information used for measuring and reporting physician and hospital outcomes to reflect the patient’s true severity of illness, the intensity of care, and risk of mortality.

•Communicating with provider face to face or via clinical documentation query forms to clarity, obtain needed documentation and educate for appropriate clinical documentation that will accurately reflect patient severity of illness and risk of mortality.

•Following up with appropriate health team members to ensure accurate and complete documentation in the medical record. Understanding of complications, HACs, PSI, co-morbidities, the severity of illness, risk of mortality, case mix, secondary diagnosis, and impact of procedures on DRG; and share this knowledge to physicians and other health team member.

•Conferring with physicians, nursing, case management, and other clinical caregivers to explain the importance of clear and concise documentation.

•Conferring with hospital coding staff to ensure appropriate DRG and completeness of supporting documentation.

•Collaborating with coders to ensure AR days remain in the target range.

•Reviewing record upon coding request to confirm DRG assignment or need to follow up with physicians regarding incomplete documentation.

•Maintaining accurate data in the tracking database.

● Providing reports and identifies trends as needed.

● Providing required/requested information, inappropriate resource utilization, statistical data, or reports for Hospital Administration, Hospital Utilization Committee, or Medical Coding.

● Achieving and maintains current knowledge and understanding of ICD-10 coding and DRG systems, through participation in education and training, including reading and comprehension of AHIMA Coding Clinic & coding guidelines.

● Experienced in an acute care setting.

● Experience in Case Management and Utilization Review pipelines, incl. reviewing denied cases.

● Experience in Clinical trial researches management.

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