Clinical Documentation Integrity Specialist
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Job Description
Remote CDI Specialist reviewing clinical records, querying providers, and managing appeals. Supporting Mosaic Life Care’s mission as a Missouri health care system through accurate coding.
Responsibilities:
- Conduct basic to intermediate initial, concurrent, and retrospective clinical documentation reviews for selected admissions
- Abstract data from concurrent and retrospective charts and computerized data systems using Official Coding Guidelines and Official Query Guidelines
- Assign and update ICD-10-CM/PCS codes and baseline and working MS-DRG and APR-DRG assignments
- Identify documentation clarification needs and communicate with providers using appropriate query tools
- Review clinical validation denials and analyze appeal recommendations
- Write first- and second-level denial appeals in collaboration with the physician advisor
- Complete second-level, mortality, and quality reviews
- Participate in staff training and departmental improvement activities
- Use quality audit results to initiate changes in practice
- Communicate with coders to ensure accurate DRG assignment
- Collaborate with interdisciplinary team members, including rounding with physicians and attending team conferences
- Participate in professional development through webinars, online education, and online meetings
- Achieve CDI quality and productivity goals
- Perform other duties as assigned
Requirements:
- Candidates must reside in Alabama, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, or Virginia for remote employment
- Associate's Degree in Nursing required
- 3 years of clinical experience in an ICU/Critical Care acute care setting required
- Registered Nurse (RN) state licensure or compact state licensure in the designated work state required upon hire
- Certified Clinical Documentation Specialist (CCDS) required within 2 years, or Certified Documentation Improvement Practitioner (CDIP) required within 2 years
- Input and retrieve data, answer phones, speak clearly, and demonstrate precise hand-eye coordination, fine motor skills, and good writing skills
- Clinical skills
- Ability to work with interruptions and flexibility in hours and workflow
- Excellent communication and critical thinking skills
- Knowledge of care delivery documentation systems and related medical record documents
- Knowledge of age-specific needs and disease processes
- Ability to read and interpret medical records, analyze encoder instructions, and understand documentation
- Ability to function independently, follow through, remain detail oriented, and prioritize work
- Ability to spend prolonged periods looking at a computer screen, keyboarding, and sitting
- Visual and hearing abilities
- Bachelor's Degree in Nursing preferred
- 1 year of experience in clinical documentation integrity functions preferred
Benefits:
- Concierge services
- Employee lounge
- Wellness programs
- Free covered parking
- Free on-site and virtual health clinics
- Compensation and recognition
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