Baptist Health South Florida

Clinical Document Integrity Specialist 2, Managed Care Network Development Med Mgmt-Boca Raton, FT, 8:30A-5P

Baptist Health South Florida$74K — $96K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Doctor of Medicine (MD) or Doctor of Osteopathy (DO) degree required.
  • International medical school graduates or Registered Nurse with MBA preferred.
  • 4 years of clinical experience in adult, pediatric, and obstetric inpatient settings required.
  • 4 years of clinical documentation improvement experience in hospital settings required.
  • CDIS certification preferred for enhanced credibility.
  • Familiarity with Milliman and Interqual standards preferred.
  • Basic computer skills, particularly with Windows-based applications, required.

Responsibilities

  • Enhance the quality and completeness of clinical documentation.
  • Collaborate with physicians and nursing staff to adjust clinical documentation.
  • Ensure accurate reimbursement for services through effective documentation practices.
  • Monitor and report on clinical outcomes for physicians and the medical center.
  • Facilitate ongoing education for the patient care team on documentation improvement processes.
  • Actively participate in team meetings to share knowledge and best practices.
  • Engage in the Clinical Documentation Management Process (CDMP) and provide staff training.

Benefits

  • Opportunities for ongoing professional development and education.
  • Ability to work collaboratively with a diverse healthcare team.
  • Engagement in meaningful projects that impact patient care and outcomes.
Full Job Description
Responsible for improving overall quality and completeness of clinical documentation through advanced concurrent review of inpatient records to support accurate, clinically valid code assignment, severity of illness and risk of mortality capture, quality outcomes, and appropriate reimbursement. Facilitates documentation modifications through extensive interaction with physicians, nursing, other caregivers, and coding staff to ensure documentation accurately reflects services rendered and the patient's clinical condition for DRG-based payors. Uses integrated health record workflows, technology-enabled review worklists, and data-informed insights to prioritize cases with the greatest documentation and clinical validation impact, ensuring accuracy of information used to measure and report provider and medical center outcomes. Provides ongoing education and coaching on documentation, best practices, regulatory expectations, and program goals and participates in team meetings and continuous improvement activities. Scope to include all inpatient payors including Medicare, Medicare Advantage, commercial, Exchange, and other applicable payors. Uses technology supported worklists, analytics, and AI assisted prioritization where available. Supports transition from CDEOne to Epic CDI workflows with planned go live in July 2027 and collaborates on DRG encoder integration such as TruBridge. Estimated salary range for this position is $74100.20 - $96330.26 / year depending on experience. Qualifications: Responsible for improving overall quality and completeness of clinical documentation through advanced concurrent review of inpatient records to support accurate, clinically valid code assignment, severity of illness and risk of mortality capture, quality outcomes, and appropriate reimbursement. Facilitates documentation modifications through extensive interaction with physicians, nursing, other caregivers, and coding staff to ensure documentation accurately reflects services rendered and the patient's clinical condition for DRG-based payors. Uses integrated health record workflows, technology-enabled review worklists, and data-informed insights to prioritize cases with the greatest documentation and clinical validation impact, ensuring accuracy of information used to measure and report provider and medical center outcomes. Provides ongoing education and coaching on documentation, best practices, regulatory expectations, and program goals and participates in team meetings and continuous improvement activities. Scope to include all inpatient payors including Medicare, Medicare Advantage, commercial, Exchange, and other applicable payors. Uses technology supported worklists, analytics, and AI assisted prioritization where available. Supports transition from CDEOne to Epic CDI workflows with planned go live in July 2027 and collaborates on DRG encoder integration such as TruBridge. Estimated salary range for this position is $74100.20 - $96330.26 / year depending on experience.Degrees: - MD / DO. Licenses & Certifications: - Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Integrity Practitioner (CDIP). Additional Qualifications: - International medical school graduates preferred; RN with advanced degree (MBA or related) may be considered. - Four years of recent adult, pediatric, obstetric, inpatient medical, surgical, and critical care experience, plus five years of CDI experience in adult/pediatric inpatient and critical care settings required. - I preferred CDI certification (CCDS or CDIP). - Experience with integrated EHRs, web-based applications, InterQual or similar tools, and technology-enabled workflow and analytics preferred. - Leadership experience and knowledge of legal aspects of coding; Medicare MS-DRG and Medicaid APR-DRG; utilization and case management, discharge planning, and managed care preferred. - Basic Windows-based computer skills required. - Knowledge of official coding guidelines, AHA Coding Clinic, CMS guidance, and compliant documentation clarification consistent with AHIMA-ACDIS query guidance required. - Experience using integrated electronic health records and CDI workflows, including readiness for transition from CDEOne to Epic CDI with planned go live in July 2027. - Experience with analytics, reporting, and AI assisted review prioritization tools preferred. - Familiarity with DRG encoder and DRG validation tools including TruBridge preferred. Minimum Required Experience: 5 Years Degrees: - MD / DO. Licenses & Certifications: - Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Integrity Practitioner (CDIP). Additional Qualifications: - International medical school graduates preferred; RN with advanced degree (MBA or related) may be considered. - Four years of recent adult, pediatric, obstetric, inpatient medical, surgical, and critical care experience, plus five years of CDI experience in adult/pediatric inpatient and critical care settings required. - I preferred CDI certification (CCDS or CDIP). - Experience with integrated EHRs, web-based applications, InterQual or similar tools, and technology-enabled workflow and analytics preferred. - Leadership experience and knowledge of legal aspects of coding; Medicare MS-DRG and Medicaid APR-DRG; utilization and case management, discharge planning, and managed care preferred. - Basic Windows-based computer skills required. - Knowledge of official coding guidelines, AHA Coding Clinic, CMS guidance, and compliant documentation clarification consistent with AHIMA-ACDIS query guidance required. - Experience using integrated electronic health records and CDI workflows, including readiness for transition from CDEOne to Epic CDI with planned go live in July 2027. - Experience with analytics, reporting, and AI assisted review prioritization tools preferred. - Familiarity with DRG encoder and DRG validation tools including TruBridge preferred. Minimum Required Experience: 5 Years

About Baptist Health South Florida

Baptist Health South Florida is a faith-based, not-for-profit healthcare organization and clinical care network in Miami as well as Broward and Palm Beach Counties. Baptist Health has 11 hospitals and in excess of 100 physician practices and outpatient facilities.
Learn more about Baptist Health South Florida

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