CDQI Nurse Specialist
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Job Description
CDQI Nurse Specialist reviewing inpatient records and querying providers for Datavant’s healthcare data platform. Improving coding specificity, DRG accuracy, and clinical documentation quality.
Responsibilities:
- Conduct timely, accurate, and complete documentation reviews for selected inpatient records, addressing inadequate or conflicting documentation
- Collaborate with physicians and caregivers to ensure appropriate reimbursement and clinical severity for DRG-based payer patients
- Apply understanding of complications, co-morbidities, severity of illness, risk of mortality, case mix index, secondary diagnoses, and procedure impact on DRG
- Educate physicians and caregivers on clear documentation to improve coding specificity
- Follow AHA guidelines and coding clinics for accurate coding and required documentation compliance
- Query physicians regarding missing, unclear, or conflicting health record documentation
- Maintain daily production logs tracking cases reviewed and queries placed/responded to
- Perform follow-up reviews to confirm points of clarification in patient medical records
- Ensure confidentiality of files, documents, and records
- Meet or exceed production and quality metrics
Requirements:
- 3+ years of CDI experience
- 3+ years of clinical experience in an academic medical center
- Registered Nurse license
- Bachelor's degree in Nursing
- CCDS or CDIP certification required
- Must pass a CDI skills competency assessment
- Must be able to accommodate a minimum of 15 hours per week
- This job is not eligible for employment sponsorship
Benefits:
- Equal Employment Opportunity employer
- Post-offer health screenings and vaccinations such as flu shot, Tdap, and COVID-19, as required by clients
- Reasonable accommodations for individuals with physical and mental disabilities
- Voluntary anonymous demographic questions that do not affect the application or hiring process
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