Clinical Documentation Integrity Specialist Nurse

Clinical Documentation Integrity Specialist Nurse

Are you a Clinical Documentation Integrity (CDI) Specialist Nurse looking to make a meaningful impact in a collaborative, mission-driven environment?

Immanuel Pathways PACE® is seeking a Clinical Documentation Integrity Specialist Nurse to join our team at our Home Office, located at 1044 North 115th Street in Omaha, NE.

Pay is based on experience, certifications, skills, and education.

Best in Class Benefits can be found at Immanuel:

• Health: Medical, dental, vision, Health Savings Account (HSA), and Flexible Spending Account (FSA)
• Life Insurance: Employer Paid Life Insurance
• Time Off: Paid Time Off - accruing from day one of employment, Floating Holidays, Paid Holidays, 8 hours of Volunteer Time Off per year
• Retirement: 401K with employer match
• Wellness: Wellness Program and Employee Assistance Program
• Growth and Development: Advancement opportunities (as appropriate) – we look to grow from within our organization, Education Assistance Program – we invest up to $5,250 per year for education assistance paid up front
• Plus many more benefits!

Job Duties & Skills Required

What You Will Do

The overall purpose of this job utilizes advanced clinical coding expertise to direct efforts towards the integrity of clinical documentation through the roles of review, educator, and consultant. Facilitates the overall quality, completeness, accuracy, severity of illness, and integrity of medical record documentation to support correct coding and reimbursement. This role bridges clinical care and administrative processes, focusing on improving recapture rates and compliance with CMS-HCC risk adjustment models. Supports and lives out Immanuel's Mission and CHRIST Promises.

Key Areas

Key Responsibilities and Duties of the Job

Clinical Documentation Improvement & Provider Engagement

• Conduct concurrent review of participant medical records to identify incomplete, inaccurate, or inconsistent clinical information.
• Initiate and manage compliant, non-leading queries to providers to clarify documentation and ensure clinical accuracy.
• Collaborate with external medical coding company to ensure that clinical documentation supports the assignment of appropriate diagnosis and procedure codes.
• Collaborate and provide on-going education and training with providers and interdisciplinary team members to clarify documentation and improve coding accuracy and the importance of complete, accurate chart documentation to support reimbursement.
• Analyze clinical data to identify documentation trends, measure of impact of improvement initiatives, and report findings to leadership.
• Serve as a subject matter expert and liaison between clinical, coding, and quality departments to resolve documentation discrepancies.
• Develop provider education curriculum relating to risk adjustment coding and documentation best practices, research and update internal coding compliance and policies in accordance with CMS-HCC (v22/V28) guidelines and ICD-10-CM/CPT II coding standards.
• Develop coding tips, newsletter articles, and clinical documentation initiatives to ensure diagnoses are documented with the specificity and detail required for Hierarchical Condition Categories (HCC).

Clinical Data

• Collaborate with Director to develop fully informed views and insights into the drivers behind data, and present findings clearly and concisely.
• Monitors and analyze data and quality review processes, evaluating results and recommending appropriate action/training.
• Prepare detailed reports for management and other departments by analyzing and interpreting data.

Other

• Assists with special project assignments.
• Performs other duties as assigned or requested.

Qualifications

Education:

• Bachelor of Science in Nursing required.

Experience:

• Five (5) years of clinical experience
• Three (3) years of experience coding ICD-10 CM and experience in ICD-10 CM in a risk adjustment environment.

• Equivalent years of education may substitute for experience requirement.

Other Requirements:

Must possess valid medical coding certification in one of the following areas:

• Certified RN Coder (CRN-C)
• Certified Clinical Documentation Specialist (CCDC)
• Certified Risk Adjustment Coder (CRC)
• Certified Coding Specialist designation (CCS)
• Certified Professional Coder (CPC)

Immanuel

At Immanuel, we believe that our success is built on the collective strength of our people. Here's why you'll thrive as part of our team:

• Meaningful work: You won't just have a job; you will have a purpose. Our Mission impacts the lives of our residents/participants and their families, one another, and our community.
• Growth Opportunities: We invest in your development. Whether it's mentorship, training, or advancement, we're committed to your growth.
• Inclusive Culture: We celebrate uniqueness and foster an environment where everyone feels valued.
• Work-Life Harmony: We believe in allowing you to thrive by leveraging your passion. Achieve your best work while maintaining a healthy work-life harmony.
• Total Rewards: A focus on feedback and recognition, competitive compensation, a robust benefits package, and perks beyond the basics.
• Intentional Experience: We are very intentional about your employee experience, from Day One Orientation to how we onboard new managers and invest in quarterly and annual leadership training.

Join us at Immanuel and be a part of something extraordinary. Your journey starts here.

• Immanuel is an Equal Opportunity Employer and participates in E-Verify.
• A background check and drug screen will be required prior to hire.
• Applicants must be currently authorized to work in the United States on a full-time basis.