Clinical Documentation Improvement Specialist

We are a community acute care medical center, part of a large neighboring academic health system,, looking for a Clinical Documentation Integrity Specialist to act as a key support for physician and physician extenders (while participating with hospital rounds) on interpretation and application of documentation integrity, and documentation standards providing complete follow-through on all requests for clarification.

Position: Clinical Documentation Integrity Specialist – HYBRID
Location: New Rochelle, NY
Salary: $100,000 – $130,000

Responsibilities:

Completes concurrentand retrospective validation of system output (principal diagnosis, pertinent secondary diagnoses, post-admission complications, Present on
Admission Status (POA), Hospital Acquired Conditions (HACS), Patient Safety Indicators (PSIs), procedures, and electronic queries for accurate Diagnosis-Related Group
(DRG) assignment and Case Mix Index (CMI), risk of mortality, and severity of illness).

Provides routine in-services to assigned clinical areas/service lines regarding regulatory documentation requirements including feedback on the impact of clinician
documentation on service specific metrics.

Minimum of 25 cases completed with deference to coding guidelines, coding clinics, and queries. Placequeries, which are supported by coding and clinical guidelines.
INCORPORATES KNOWLEDGE OF CMS AND NEW YORK STATE HOSPITAL PERFORMANCE AND QUALITY PROGRAMS INTO RECORD REVIEWS.
Completion of routine presentations to assigned service
areas, which have statistical and coding support.

Participates in the analysis and trending of statistical data for specified patient populations to identify opportunities for performance improvement (i.e.: trends responses to
queries and completion, service line statistics, population specific query opportunities).

Ability to identify service line and associate Clinical Documentation Opportunities based on reports and associated data.

Requirements:

Must have a Bachelor’s Degree and certification in one of the fdllowing CCS, CDIP, RN,PA, NP, MD, or CCDS
Prefers prior hospital inpatient CDI erxperience or strong DRG Inpatient experience
Knowledge of Microsoft Excel, Power Point, Iodine CDI System, Outlook and Working knowledge of Medicare, and All Payer Refined, reimbursement systems and coding
structures.
Prior experience in training peers and expertise in group presentations
Knowledge of coding concepts and related to coding or experience with hospital finance or hospital billing.
Excellent verbal and written communication skills