Senior Consultant

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

📋 Description

• Assess medical records as assigned to ensure complete and precise documentation of all pertinent diagnoses and procedures.

• Offer ad-hoc assistance to Customer leadership related to current Clinical Documentation Integrity (CDI) processes and practices, which includes attending customer meetings and sharing insights through CDI metrics.

• Identify opportunities for improved documentation within medical records previously reviewed or not reviewed by other Clinical Documentation Integrity Specialists.

• Analyze queries from a compliance standpoint to identify any risk areas, using the ACDIS/AHIMA Practice Brief as a benchmark.

• Evaluate compliance with Customer-specific CDI processes and procedures.

• Follow guidelines established by ACDIS, AAPC, and AHIMA.

• Show a comprehensive understanding of healthcare business aspects, including MS and APR DRG payer issues, audit risks, documentation opportunities, POA, quality metrics, hierarchical condition categories, and various risk adjustment methodologies.

• Collaborate closely with the Customer, colleagues, and management to fulfill the specific needs of each assignment while aligning with core values.

• Effectively use computer software according to specific Customer requirements.

• Provide constructive feedback to fellow CDI Auditors.

• Maintain the confidentiality of all patient information in compliance with HIPAA regulations.

⛳️ Requirements

• The candidate must hold a current RN license.

• A minimum of 3 years of clinical documentation experience in an acute care facility is required.

• At least 3 years of consulting experience is necessary.

• A minimum of 2 years of CDI auditing and/or second-level review experience is required.

• Experience with Solventum 360 reporting is essential.

• A thorough understanding of both MS and APR DRG methodologies, as well as Compliant Query Practices as defined by ACDIS/AHIMA, is necessary.

• Strong analytical skills for clinically evaluating medical records are essential.

• Ability to independently utilize multiple computer applications for medical record review and proficiency in Microsoft products (Excel, Word, Outlook) is required.

• Effective communication skills with e4health management and Customers are essential.

• Proficiency in ICD-10-CM and ICD-10-PCS is required.

🏝️ Benefits

• Comprehensive benefits package, including a 401(k) with company match.

• Medical, dental, and vision insurance.

• Life insurance coverage.

• Short and long-term disability insurance.

• Paid Time Off (PTO) policy.