CDI Specialist I

Remote Clinical Documentation Integrity Specialist

The Remote Clinical Documentation Integrity (CDI) Specialist is accountable for reviewing patient medical records in the inpatient and/or outpatient setting to capture accurate representation of the severity of illness and facilitate proper coding. Needing a CDI that has experience with Risk Adjustment Tools like Vizient, Elixhauser, HCC's, SOI/ROM. Specifically we are looking for risk adjustment for expected mortality methodologies and CMS measures (mortality and readmissions). The CDI Specialist validates that coding reflects medical necessity of services and facilitates appropriate coding which provides an accurate reflection and reporting of the severity of the patient's illness along with expected risk of mortality and complexity of care. Documentation of discharge diagnoses and co-morbidities are a complete reflection of the patient's clinical status and care. Utilizes advanced knowledge of disease processes (pathophysiology), medications, and have critical thinking skills to analyze current documentation to identify gaps. Identifies opportunities in concurrent and retrospective inpatient clinical medical documentation to support quality and effective coding. Understands and applies regulatory compliance related to documentation, coding and billing for all health insurance plans. The CDI Specialist facilitates appropriate modifications to documentation through extensive interactions and collaboration with physicians, coding, case management, nursing and other care givers. Serves as an effective change agent as an educator and resource for physicians and allied health staff to improve the quality and completeness of the clinical documentation. Performs all duties and responsibilities in accordance with ethical and legal business procedures, compliant with federal and state statutes and regulations, official coding rules, guidelines and accepted standards of coding practice including appropriate clinical documentation policies.

Minimum Education and/or Experience Required:

• Two years of experience in an Inpatient Clinical Documentation Integrity Specialist (ICDIS) role, concurrent review of medical records in the field of CDI and experience in a production role within the last 12 months.
• MUST have the (CCDS) or the (CDIP) certification AND Any of the following: (RHIT), (CCS), (CCS-P), (RN), completion of international or domestic medical program or, Formal education (accredited college-level course work) in human anatomy and physiology, medical terminology, and disease process or, Associate's degree or higher (candidates must also have completed coursework in medical terminology and anatomy and physiology).
• Demonstrated skills in analytical thinking and problem solving.
• Effective verbal and written communication including ability to present ideas and concepts effectively to physicians, management, and other members of our healthcare team.
• Self-motivated and able to work independently without close supervision.
• Demonstrated ability to work well with others in a creative and challenging work environment.
• Must be able to work flexible hours which may include evenings and weekends as required to meet business needs.

Preferred Qualifications:

• 5yrs Academic Level I Trauma facility experience
• Bachelor of Science – Nursing (BSN), CCS credentials
• Proficient with EPIC & 3M360 CAC
• Extensive knowledge and experience working in a ICU and Mortality Reviews
• Strong communication (written/verbal) with experience in writing queries
• Must be technically savvy

Number of Weeks: 13 weeks with possible extension

Working Hours Needed: Sun-Thurs schedule. Mandatory OT is expected, along with working the holiday when the holiday falls during the Sun-Thurs. schedule (unless the contractor is taking paid time off). The onboarding schedule will be Mon-Fri for appr. 3-4 weeks (maybe a little longer, if needed), prior to switching to the Sun-Thurs. schedule.

License/Credentials Req:

• MUST have the (CCDS) or the (CDIP) certification AND Any of the following: (RHIT), (CCS), (CCS-P), (RN), or completion of international or domestic medical program or, Formal education (accredited college-level course work) in human anatomy and physiology, medical terminology, and disease process or, Associate's degree or higher (candidates must also have completed coursework in medical terminology and anatomy and physiology).

Compensation & Benefits:

• Pay Range: Paid weekly a very competitive hourly rate
• Health & Dental
• PTO, Sick Time, 6 paid holidays
• 401K, Weekly Pay