RN Educator, Clinical Documentation Integrity
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Job Description
RN Educator strengthening clinical documentation integrity at Denver Health, Colorado’s safety-net healthcare system. Training CDI teams, auditing records, and educating providers on compliant documentation.
Responsibilities:
- Facilitate improvement in the quality, completeness, and accuracy of medical record documentation
- Educate and train the Clinical Documentation Integrity team
- Conduct extensive audit investigations, clinical criteria research, and data analysis
- Develop, facilitate, and coordinate organizational CDI educational efforts, including formalized orientation and ongoing education
- Perform concurrent and retrospective reviews, quality reviews, and internal compliance and performance audits as requested by the CDI Manager
- Support clinical review for new technologies and projects
- Educate providers regarding documentation specificity, accuracy, and compliance
- Draft and submit written queries to providers to clarify documentation
- Educate providers, coders, and CDI team members on clinical documentation concepts, health data, quality outcomes, and compliance regulations
- Partner with Revenue Integrity and Compliance teams on appeals and education related to coding and documentation denials
- Inform new technology projects affecting CDI workflows, provider queries, and program outcomes
- Collaborate with Coding, HIM, Patient Safety and Quality, Enterprise Compliance Services, Revenue Integrity, and other departments
Requirements:
- Bachelor's Degree in Nursing or related field, or Associate's Degree with equivalent level of additional experience — required
- 7–9 years of nursing experience with at least 2 years in an acute care setting — required
- 1–3 years of CDI, clinical coding, DRG coordination, or Medicare/Medicaid reimbursement experience — required; may be included in the 7–9 years above
- 1–3 years of experience in education or supervisory experience preferred
- RN-Registered Nurse license from DORA (Department of Regulatory Agencies) — required
- Knowledge of clinical criteria, pathophysiology, evidence-based practice, and current medical treatment trends
- Clinical expertise in urgent/emergent, medical/surgical, obstetrical, pediatric, and ambulatory care
- Knowledge of CMS Medicare, Medicaid, Managed Care, and Commercial health plan billing, reimbursement, and regulations
- Knowledge of value-based purchasing, bundled payments, accountable care organizations, readmission reduction programs, and public reporting of quality outcomes
- Knowledge of ICD-10-CM, ICD-10-PCS, Official Coding Guidelines, Coding Clinics, and other coding references
- Knowledge of quality measures, patient safety indicators, value-based purchasing, risk adjustments, mortality scoring, hospital-acquired conditions, CMS 5 Star, and external publicly reported quality metrics
- Knowledge of compliance practices, briefs, white papers, and publications guiding ethical and legal CDI practices
- Proficiency with multi-platform computer software and applications for tracking, analyzing, calculating, and summarizing data and qualitative findings
- Proficiency with Microsoft Suite
- CDI or Coding certification preferred
- All job applicants for safety-sensitive positions must pass a pre-employment drug test after a conditional offer
Benefits:
- Paid time off starting at 28 days per year, inclusive of vacation, personal/sick, and 7 Holidays
- 100% paid parental leave up to 6 weeks
- Immediate eligibility for retirement plans with employer contribution up to 9.5%
- Generous medical, dental, vision plans
- Employer-paid disability and life insurance
- Comprehensive well-being programs, including an on-site employee fitness center and RESTORE Center
- Free RTD EcoPass (public transportation)
- Childcare discount programs and exclusive perks on large brands, travel, and more
- Tuition reimbursement and assistance
- Education, coaching, and professional development opportunities through the Workforce Development Center
- Professional clinical advancement program and shared governance
- Public Service Loan Forgiveness (PSLF) eligible employer
- Free student loan coaching and assistance navigating the PSLF program
- National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer
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