Clinical Documentation Integrity (CDI) Specialist

Primary Responsibilities

• Perform concurrent and retrospective chart reviews for improving the overall completeness of clinical documentation
• Keep abreast of current coding trends and maintains up to date knowledge of Medicare rules and regulations regarding diagnosis coding and CDI trends
• Effectively utilizes ICD-10 and related materials to investigate coding issues and produce accurate results
• Cultivates daily follow-up communication with providers regarding existing clarifications to obtain needed documentation specificity
• Provides expert level leadership for overall improvement in clinical documentation by providing proficient review and assessment, and effectively articulates recommendations for improvement including the rationale for the recommendations
• Actively communicates with providers at all levels, to clarify information and to communicate documentation requirements for appropriate diagnoses based on severity of illness and risk of mortality
• Provides complete follow through on all requests for clarification or recommendations for improvement
• Ensures effective utilization of Technology to document all clarification activity
• Collaborates closely with interfacing departments such as Care Coordination and Quality
• Utilizes only the Optum/client approved clarification forms
• Proactively develops a reciprocal relationship with the HIM Coding Professionals
• Engages and consults with Physician Advisor/CMO when needed, per the hospital defined escalation process, to resolve provider issues regarding answering clarifications and participation in the clinical documentation integrity process

Required Qualifications

• Undergraduate degree or equivalent experience
• 5+ years acute care hospital clinical RN experience OR Medical Graduate with CDI experience
• Advanced proficiency in clinical medicine, pathophysiology, and pharmacology
• Advanced proficiency communicating & working closely with Physicians
• Intermediate proficiency using a PC in a Windows environment, including Microsoft Word, Excel, Power Point and Electronic Medical Records

Preferred Qualifications

• Experience interacting with Providers providing concurrent/chart review
• Proven comfortable with technology

Pay

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.

Benefits

Our mission of helping people live healthier lives extends to our team members. Learn more about our range of benefits designed to help you live well.