R1 RCM · 4 hours ago

Senior CDI Specialist

United States

Full-time

Remote

Mid, Senior Level

$65K/yr - $81K/yr

2+ years exp

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Responsibilities

Reviews clinical documentation to facilitate the accurate representation of the severity of illness, expected risk of mortality, and complexity of care by improving the quality of the physician's clinical documentation.

Conduct focused reviews in areas identified by CDI leadership: Mortality reviews, PSI reviews, as well as other identified projects.

Serve as a subject matter expert and authoritative resource on interpretation and application of CDI practices, coding rules, and regulations and conducts risk assessments of potential and detected compliance deficiencies, as well as documentation improvement opportunities.

Initiates physician query when ambiguous, missing, or conflicting information is in the medical record, through the physician query process and/or participation in rounding with the physicians by requesting additional documentation for correct coding and compliance necessary for accurate reflection of CMI, LOS, and optimal resource utilization.

Partners with the HIMS coding staff to ensure the accuracy of diagnostic and procedural data and completeness of supporting documentation to determine a working and final DRG, severity of illness, risk of mortality, and quality outcomes.

Qualification

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CDI experienceMS-DRG reviewsAPR-DRG reviewsRN licenseCCS CertificationCDI CertificationCCDSCDIPCRCRCPHQBasic computer skills