Urgently Need Clinical Documentation Integrity (CDI) Specialist- 2nd Level Reviewer- Remote in Washington DC

Job title: Clinical Documentation Integrity (CDI) Specialist- 2nd Level Reviewer- Remote

Company: Dovel Technologies

Job description: Job Family: CDI Specialist



Travel Required: None



Clearance Required: None



What You Will Do:



The CDI Specialist- 2nd Level Reviewer responsibilities include comprehensive secondary clinical chart reviews to identify potential missed opportunities for documentation clarification, act as a liaison between coding and CDI to resolve DRG or other code discrepancies, collaborate as a CDI educator to educate CDI team based on opportunities identified in second level reviews and work directly with clinicians and providers to improve the overall quality and completeness of documentation through the query process and/or provider education. The Clinical Documentation Integrity Second Level Reviewer will collaborate closely with Coders, Coding Educators, Coding Quality Auditors, Case managers, Quality Department and Providers to assure documentation is clinically appropriate, accurately reflects the severity of illness and risk of mortality for the patient and is reflective of current CMS or other regulatory standards.

• Analyzes and interprets clinical data to identify gaps, inconsistencies, and/or opportunities for improvement in the clinical documentation and queries the provider using concurrent query process following ACDIS/AHIMA Guidelines for Compliant Query Writing.


• Work with CDI leadership to plan, develop, and implement clinical documentation education programs for CDI specialists and providers.


• Utilizes comprehensive knowledge of ICD-10-CM coding guidelines and clinical knowledge to educate coding and CDI staff on best practice principals.


• Work on efforts to improve provider clinical documentation and providing an accurate clinical picture of the patient including severity of illness, risk, and resource utilization.


• Conduct individual and large group educational sessions for all CDI Specialists and/or providers.


• Performs monthly CDI audits and reviewing for educational opportunities.


• Working closely with the CDI Specialists, identify areas of non-specific documentation and improve documentation templates in support of clinical treatment protocols.


• Communicates findings of secondary reviews to respective Clinical Documentation Specialist for follow-up and query initiation.


• Completes comprehensive, clinical secondary reviews of targeted patient populations to include cases with DRG and/or code discrepancies; mortality reviews to ensure documentation supports risk of mortality; hospital acquired conditions (HACs), patient safety indicators (PSIs) or other top priority diagnosis as identified by UAB for potential missed opportunities to clarify documentation or clinically validate a diagnosis.


• Acts as a liaison between the Coding Department and the Clinical Documentation Specialist to reconcile discrepancies in code and/or DRG assignment.


• Documents and tracks second level reviews and results. Shares this information with staff at monthly CDI team meeting.


• Collaborative interaction with physicians and/or other clinicians to enhance understanding of the CDI program goals; ensure the medical record can be coded accurately in order to accurately reflect patient severity of illness and risk of mortality.

What You Will Need:

• Graduation from accredited School of Nursing with BSN, ADN, OR Bachelor?s Degree or Masters Degree in health related field OR graduation from accredited medical school with MD or DO


• Currently licensed or licensed by endorsement as a Registered Nurse, MD or MD equivalent OR credentialed medical coder with current CCS credential


• Minimum of three to five years as a Clinical Documentation Integrity Specialist required.


• Exhibits strong clinical, critical thinking skillset


• Experience providing education to CDI teams.


• Ability to perform monthly audits.


• Experienced Clinical Documentation Integrity Specialist (minimum 3-5 years) or CDI Second Level Reviewer with a strong understanding of disease processes, clinical indications and treatments; provider documentation requirements to support the diagnosis/procedures performed for accurate clinical coding and billing according the rules of Medicare, Medicaid, and commercial payors as well as a solid understanding of hospital acquired conditions (HAC?s) , patient safety indicators (PSI?s) and mortality models.


• Experience with encoder and DRG assignments (MS and APR)


• Maintains working knowledge of Official Coding Guidelines, Coding Clinic and federal updates to the DRG system


• Ability to conduct meaningful conversations and/or presentations with providers in all situations


• Excellent communication skills, with ability to listen and understand client request and needs while employing tact and effectiveness


• Must maintain credentials while employed

What Would Be Nice To Have:

• CCS preferred (exception required by coder)


• CCDS or CDIP certification


• Previous Vizient experience


• Previous Optum CAC experience

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The annual salary range for this position is $95,800.00-$143,800.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.



What We Offer:



Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.



Benefits include:



Medical, Rx, Dental & Vision Insurance



Personal and Family Sick Time & Company Paid Holidays



Position may be eligible for a discretionary variable incentive bonus



Parental Leave



401(k) Retirement Plan



Basic Life & Supplemental Life



Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts



Short-Term & Long-Term Disability



Tuition Reimbursement, Personal Development & Learning Opportunities



Skills Development & Certifications



Employee Referral Program



Corporate Sponsored Events & Community Outreach



Emergency Back-Up Childcare Program



About Guidehouse

Guidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.



Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.



If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.



Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.

Expected salary: $95800 - 143800 per year

Location: Washington DC

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