Pena4 · 2 days ago
Clinical Documentation Integrity Specialist (CDIS), RN
United States
Contract
Remote
Senior Level
$60/hr - $65/hr
6+ years expPena4 is a not-for-profit health system that includes multiple hospitals and is seeking a Clinical Documentation Integrity Specialist (CDIS), RN. This role focuses on ensuring the accuracy and completeness of clinical documentation for inpatient hospitalizations, involving thorough reviews and communication with clinical staff to ensure proper coding and compliance with regulations.
ConsultingOutsourcingStaffing Agency
Hiring Manager
Jada Dos Santos
Responsibilities
CDIS are responsible for meeting the below client established KPI’s:
Review Rates: 100% of all payors inpatient cases (excludes Mother/Baby/NTU, NICU)
CDI RN query rate to physicians should be approximately 30%
Physician Response Rate: Physicians should respond to approximately 95-100% of queries
Frequency of Concurrent: Reviews will be daily
Review for all patients with inpatient status will be done 24–36 hours post admission
Identify and communicate with the physician the appropriate selection of the principal diagnosis, complications, co-morbidities, POA criteria or history of the patient in order to reflect the most appropriate severity of illness and risk of mortality
Facilitate educational opportunities for the physicians and physician extenders and provide for a better understanding on how to capture the most accurate patient profile that reflects the patient’s severity of illness and risk of mortality
Develop strategies and work in a collaborative manner with HIM/coders that enable all documentation to be collected and coded, that reflects the most accurate patient profile
Provide administration with data analyzed for Monitoring, Compare, and Profile reports regarding patient and facility data
Monitor reports for CDI productivity and coding and physician opportunity
Assist with other projects as needed
Qualification
Required
Registered Nurse (RN) required
Certified Clinical Documentation Specialist (CCDS) required
Certified Coding Specialist (CCS) required
6+ years acute care experience in a Level 1 or level 2 trauma and academic medical center
3+ years' experience in a production CDI role with demonstrated track record of meeting the client established KPIs
Working knowledge of electronic medical records systems (Cerner and Optum experience required)
Work knowledge of Severity of illness and Risk of Mortality
Work knowledge of HCC
Work knowledge of Intensity of service/resource consumption
Work knowledge of Length of stay
Work knowledge of Treatment complexity
Work knowledge of ICD-10-CM coding
Work knowledge of DRG assignment
Work knowledge of Regulatory Compliance
Work knowledge of POA if determined
Overall knowledge of the flow of the revenue cycle
Motivate and maintain effective working relationships with staff and all stakeholders
Ability to work independently in a remote office setting
Experience with Microsoft applications (Word, Outlook, Excel and PowerPoint)
Expert knowledge of ICD-10-CM/PCS coding, DRG reimbursement systems, and medical terminology
Strong clinical reasoning and ability to interpret complex inpatient cases
Excellent verbal and written communication skills to interact with clinicians and multidisciplinary teams
Critical thinking and investigative skills to review and analyze patient records
Ability to work independently in a high-volume environment
Familiarity with EHR systems (Cerner and Optum)
Preferred
Bachelor of Science in Nursing (BSN) preferred
Company
Pena4
Pena4 is an outsourcing/offshoring company that provides services like staffing, consulting, coding, CDI and CDM.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Manny Peña
Chairman & CEO
Joseph J. Gurrieri, RHIA, CHP
President & COO
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