RN Educator, Clinical Documentation Integrity

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

📋 Description

• Enhance the quality, completeness, and accuracy of medical record documentation.

• Provide education and training to the Clinical Documentation Integrity team.

• Perform thorough audit investigations, clinical criteria research, and data analysis.

• Create, lead, and manage organizational CDI educational initiatives, which include formal orientation and ongoing training.

• Conduct concurrent and retrospective reviews, quality assessments, and internal compliance and performance audits as directed by the CDI Manager.

• Assist in clinical reviews for new technologies and projects.

• Guide providers on documentation specificity, accuracy, and compliance.

• Compose and submit written queries to providers for clarification of documentation.

• Instruct providers, coders, and CDI team members on clinical documentation concepts, health data, quality outcomes, and compliance regulations.

• Collaborate with Revenue Integrity and Compliance teams regarding appeals and education related to coding and documentation denials.

• Communicate new technology projects that impact CDI workflows, provider queries, and program outcomes.

• Work in partnership with Coding, HIM, Patient Safety and Quality, Enterprise Compliance Services, Revenue Integrity, and other departments.

⛳️ Requirements

• Bachelor's Degree in Nursing or a related field, or an Associate's Degree with equivalent additional experience — required.

• 7–9 years of nursing experience, including at least 2 years in an acute care environment — required.

• 1–3 years of experience in CDI, clinical coding, DRG coordination, or Medicare/Medicaid reimbursement — required; this may be part of the 7–9 years mentioned above.

• 1–3 years of educational or supervisory experience preferred.

• RN-Registered Nurse license from DORA (Department of Regulatory Agencies) — required.

• Familiarity with clinical criteria, pathophysiology, evidence-based practice, and current medical treatment trends.

• Clinical expertise in urgent/emergent, medical/surgical, obstetrical, pediatric, and ambulatory care settings.

• Understanding of CMS Medicare, Medicaid, Managed Care, and Commercial health plan billing, reimbursement, and regulations.

• Knowledge of value-based purchasing, bundled payments, accountable care organizations, readmission reduction programs, and public reporting of quality outcomes.

• Proficiency in ICD-10-CM, ICD-10-PCS, Official Coding Guidelines, Coding Clinics, and other coding references.

• Awareness of quality measures, patient safety indicators, value-based purchasing, risk adjustments, mortality scoring, hospital-acquired conditions, CMS 5 Star ratings, and externally reported quality metrics.

• Understanding of compliance practices, briefs, white papers, and publications that guide ethical and legal CDI practices.

• Proficient with multi-platform computer software and applications for tracking, analyzing, calculating, and summarizing data and qualitative findings.

• Proficient in Microsoft Suite.

• CDI or Coding certification preferred.

• All applicants for safety-sensitive roles must pass a pre-employment drug test after a conditional offer is made.

🏝️ Benefits

• Paid time off starting at 28 days per year, covering vacation, personal/sick leave, and 7 holidays.

• 100% paid parental leave for up to 6 weeks.

• Immediate eligibility for retirement plans with employer contributions of up to 9.5%.

• Comprehensive medical, dental, and vision plans.

• Employer-sponsored disability and life insurance.

• Extensive well-being programs, including an on-site employee fitness center and RESTORE Center.

• Complimentary RTD EcoPass for public transportation.

• Childcare discount programs and exclusive offers on major brands, travel, and more.

• Tuition reimbursement and assistance available.

• Opportunities for education, coaching, and professional development through the Workforce Development Center.

• Professional clinical advancement program and shared governance initiatives.

• Eligible employer for Public Service Loan Forgiveness (PSLF).

• Access to free student loan coaching and guidance on navigating the PSLF program.

• Eligible employer for National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC).