RN Educator, Clinical Documentation Integrity

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

📋 Description

• Facilitate enhancements in the quality, completeness, and accuracy of medical record documentation.

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

• Conduct comprehensive audit investigations, clinical criteria research, and data analysis.

• Develop, facilitate, and coordinate organizational CDI education, including structured orientation and ongoing training strategies.

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

• Assist with clinical reviews for new technologies and initiatives.

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

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

• Create and deliver CDI orientation utilizing industry-approved content, adult learning methods, and subject matter expertise.

• Collaborate with the CDI Manager to conduct internal audits validating query compliance and identifying educational opportunities.

• Provide education to providers, coders, and the CDI team on clinical documentation, health data, quality outcomes, and compliance regulations.

• Partner with Revenue Integrity and Compliance teams concerning appeals and education related to coding and documentation denials.

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

• Work collaboratively with Coding, Health Information Management, 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 a minimum of 2 years in an acute care setting — required.

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

• 1–3 years of experience in education or supervisory roles — preferred.

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

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

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

• 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, and publicly reported quality metrics.

• Knowledge of CDI compliance practices, practice briefs, white papers, and ethical and legal guidelines.

• 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.

• Strong critical thinking skills with the ability to autonomously prioritize tasks, manage time, and maintain organization.

• Capability to communicate complex concepts to physicians and healthcare professionals.

• Ability to read and interpret professional journals, financial reports, and legal documents.

• Skill in defining problems, collecting and summarizing data, establishing facts, and drawing conclusions.

• Must reside in Colorado.

• All applicants for safety-sensitive positions must successfully pass a pre-employment drug test following a conditional offer.

🏝️ Benefits

• Paid time off starting at 28 days per year, which includes 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%.

• Generous medical, dental, and vision plans.

• Employer-covered disability and life insurance.

• Comprehensive well-being programs.

• On-site employee fitness center.

• Nationally recognized RESTORE Center.

• Complimentary RTD EcoPass (public transportation).

• Childcare discount programs.

• Exclusive perks with major brands, travel, and more.

• Tuition reimbursement and assistance.

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

• Professional clinical advancement program and shared governance.

• Public Service Loan Forgiveness (PSLF) eligible employer.

• Free student loan coaching and assistance navigating the PSLF program.

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