Clinical Documentation Integrity Specialist

Full-Time Days

Summary:

Facilitates concurrent documentation of the medical record to achieve accurate inpatient coding and DRG assignments to ensure the principal diagnosis, comorbidities and principal procedure are appropriate and supported for reimbursement. Reviews chart documentation for quality metric indicators for severity of illness (SOI), risk of mortality (ROM), and risk adjusters (readmission criteria). Educates physician on documentation needs through the query process. Directly works with Physician Advisors as well as the patient's physician to establish concise physician documentation; ensures physician awareness of documentation guidelines in relation to coding guidelines that support appropriate reimbursement. If any type of nursing judgement, nursing practice or medical judgement questions should arise, those questions/concerns will be elevated to the Chief Nurse Executive (CNE).

Formal Education Required:
a. Graduate of accredited health information management or coding program or a school accepted for candidacy status from an accrediting body

OR

b. Graduate of an accredited school of professional nursing or a school accepted for candidacy status from an accrediting body
c. RHIA, RHIT, CCA, CCS, CCDS, CDIP, CPCH, or CDIP certification preferred

Experience & Training Required:
a. One (1) year medical records experience (practicum experience will be counted) if graduate of health information management or coding program
b. Two (2) years professional nursing experience which should include a combination of medical, specialty and/or surgical care in an acute care setting or utilization review with DRG validation experience if minimum education level is graduate of nursing school

Other Skills, Competencies and Qualifications:
a. 75% or better on a CDI Specialist Test
b. Excellent communication both verbally and written, leadership, organization and interpersonal skills.
c. Ability to work within a team environment yet self-motivated, facilitate strategic development, knowledge of accrediting, licensing and compliance requirements
d. Extensive knowledge of coding guidelines required
e. Extensive knowledge of clinical processes required
f. Ability to work in a sometimes stressful environment
g. Population Specific Competency: ability to effectively interact with populations of patients/customers with an understanding of their needs for self-respect and dignity.

Level of Physical Demands:
a. Sedentary: Exerts up to ten pounds of force occasionally and/or a negligible amount of force frequently.

$37.40/hr - $56.11/hr
The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.

Summa Health offers a competitive and comprehensive benefits program to include medical, dental, vision, life, paid time off as well as many other benefits.

• Basic Life and Accidental Death & Dismemberment (AD&D)
• Supplemental Life and AD&D
• Dependent Life Insurance
• Short-Term and Long-Term Disability
• Accident Insurance, Hospital Indemnity, and Critical Illness
• Retirement Savings Plan
• Flexible Spending Accounts - Healthcare and Dependent Care
• Employee Assistance Program (EAP)
• Identity Theft Protection
• Pet Insurance
• Education Assistance
• Daily Pay