Revenue Cycle CDI Specialist

About the role

The Revenue Cycle CDI Specialist is responsible for reviewing medical records to facilitate and obtain appropriate provider documentation for clinical conditions and/or procedures to support the appropriate DRG assignment, severity of illness, expected risk of mortality, and complexity of care of the patient, by improving the quality of the providers' clinical documentation. The CDS exhibits clinical expertise and clinical documentation improvement practices, as well as knowledge of compliant coding practices, adherence to AHIMA/ACDIS Guidelines for Achieving a Compliant Query Practice. Acts as a liaison between providers, clinical quality, patient financial services, etc. to ensure collaborative relationships resulting in accuracy and integrity of the inpatient medical record. Educates members of the patient care team regarding documentation guidelines, including attending providers, allied health practitioners, nursing, quality and case management.

Responsibilities

• Completes initial medical records reviews within 24-48 hours of admission for a specified patient population to evaluate documentation to assign the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate DRG assignment, risk of mortality and severity of illness
• Conducts follow-up reviews every 2-3 days to support working DRG assignment
• Formulates compliant provider queries regarding missing, unclear or conflicting documentation, as necessary
• Follows up daily on open queries with providers to ensure timely responses
• Reviews final coding DRG assignment follows DRG reconciliation process
• Keeps abreast of Official Coding and Reporting Guidelines, AHA Coding Clinics, CMS and other agency directives and maintains up to date knowledge of coding and CDI current trends
• Strong oral communication skills and the ability to deliver presentations to large groups
• Actively seeks to promote and helps to maintain a professional, team-oriented, service-conscious environment, which contributes to the goals of the team and reflects the values of the enterprise
• Proactively develops a collaborative relationship with the HIM Coding Professionals
• Collaborates with leadership when needed, per the escalation process, to resolve provider issues regarding answering clarifications and participation in the clinical documentation improvement process
• Able to troubleshoot computer issues in a timely fashion while working remotely

Requirements

• Bachelor's of Nursing and/or Bachelor’s degree in Nursing, or HIM
• CAC experience (Computer Assistant Coding), Preferred
• 2 years’ acute care hospital clinical CDI experience
• 2 years’ experience inpatient coding auditor
• Experience with various encoder and EMR systems (Optum eCAC, Solventum, EPIC, Cerner, Meditech)

Qualifications

• Registered Health Information Technician (RHIT), Required
• Certified Coding Specialist (CCS), Required
• Registered Nurse:XX (RN:XX), Required
• Certified Cardiac Device Specialist (CCDS), Preferred
• Clinical Documentation Improvement Professional (CDIP), Preferred
• Certified Coding Specialist (CCS), Preferred

Skills

• Strong oral communication skills
• Ability to troubleshoot computer issues

Benefits

Includes but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time.

Pay

$39.27 - $64.80 /hour

Schedule

Monday - Friday, 80 hours per week