CDQI Nurse Specialist

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

📋 Description

• Perform thorough, timely, and accurate reviews of documentation for selected inpatient records, addressing any inadequate or conflicting information.

• Collaborate with physicians and caregivers to ensure appropriate reimbursement and clinical severity for patients covered by DRG-based payers.

• Utilize understanding of complications, co-morbidities, severity of illness, risk of mortality, case mix index, secondary diagnoses, and the impact of procedures on DRG.

• Provide education to physicians and caregivers on clear documentation practices to enhance coding specificity.

• Adhere to AHA guidelines and coding clinics to ensure precise coding and compliance with required documentation standards.

• Inquire with physicians about missing, unclear, or conflicting documentation in health records.

• Keep daily production logs to track reviewed cases and queries that have been placed or responded to.

• Conduct follow-up reviews to verify points of clarification in patient medical records.

• Maintain the confidentiality of files, documents, and records.

• Achieve or surpass production and quality metrics.

⛳️ Requirements

• A minimum of 3 years of CDI experience.

• At least 3 years of clinical experience within an academic medical center.

• Valid Registered Nurse license.

• Bachelor's degree in Nursing.

• CCDS or CDIP certification is mandatory.

• Successful completion of a CDI skills competency assessment is required.

• Availability to accommodate a minimum of 15 hours each week.

• This position does not qualify for employment sponsorship.

🏝️ Benefits

• Equal Employment Opportunity employer.

• Post-offer health screenings and vaccinations, such as flu shots, Tdap, and COVID-19, as required by clients.

• Reasonable accommodations available for individuals with physical and mental disabilities.

• Voluntary anonymous demographic questions that do not influence the application or hiring process.