CDI Quality Reviewer

This is a fully remote position, open to applicants in Texas.

📋 Description

• Perform thorough secondary clinical chart assessments for designated patient groups.

• Detect missed chances for enhancing documentation clarity and validating clinical details.

• Examine DRG and coding discrepancies, mortality assessments, HACs, PSIs, and key diagnoses.

• Evaluate clinical data to uncover documentation deficiencies, inconsistencies, and areas for improvement.

• Engage with providers through the concurrent query process, adhering to ACDIS/AHIMA compliant query protocols.

• Act as a liaison between Coding and Clinical Documentation Integrity to resolve coding and DRG inconsistencies.

• Report secondary review outcomes and monitor review results for the Manager.

• Collaborate with the CDI Educator/Auditor to meet educational requirements.

• Investigate and stay updated on clinical and coding regulations, including quarterly Coding Clinics and ICD-10.

• Contribute to the quality, punctuality, and completeness of health records.

• Work alongside physicians and clinicians to enhance the understanding of the CDI program and the quality of documentation.

• Ensure that records accurately depict patient severity of illness and risk of mortality.

• Follow Memorial Hermann's policies, procedures, safety standards, productivity, and quality expectations.

• Assist in achieving department objectives and act as a resource for less experienced personnel.

• Undertake additional responsibilities as assigned.

⛳️ Requirements

• Bachelor’s degree in Nursing is required.

• Valid State of Texas license or temporary/compact license for professional nursing practice.

• Must possess one of the following: Certified Clinical Documentation Specialist (CCDS), Certified Clinical Documentation Integrity Professional (CDIP), or Certified Coding Specialist (CCS).

• A minimum of three (3) years of experience in Clinical Documentation Integrity (CDI) is required.

• Proficient in computer skills, including MS Office—Word, Excel, and Outlook—and 3M Coding and Reimbursement software.

• Exceptional communication, analytical, and problem-solving abilities.

• Strong organizational skills with a keen attention to detail.

• Solid skills in risk assessment, impact analysis, and problem resolution.

• Capability to operate independently, follow directions, and collaborate effectively within a team.

• Adaptability, multitasking, and the ability to prioritize daily tasks are essential.

• Master’s Degree in Nursing or Management is preferred.

• Approval as an AHIMA ICD-10-CM/PCS Trainer is preferred.

• Prior experience in CDIS auditing, denial management, and Vizient is preferred.

• Familiarity with Epic EMR is preferred.

• CDI experience is necessary for consideration.

🏝️ Benefits

• Support for mandatory/continuing education and skills competency development.

• Opportunities for professional growth and development.

• A supportive workplace culture centered on employee well-being.

• Compassionate and personalized experiences for both employees and community members.