CDI Lead Specialist - St. Joseph Medical Center

Conifer Revenue Cycle Solutions • Tacoma, WA

91d • $98,670 - $147,980

About The Position

The position involves educating members of the patient care team regarding documentation guidelines, including attending physicians, allied health practitioners, nursing, and case management. The role includes overseeing department workflow and metrics, creating reports for strategic decisions, and training department staff. The individual will be responsible for reviewing medical records to ensure appropriate physician documentation for clinical conditions or procedures, thereby improving the quality of clinical documentation.

Requirements

• Three or more years of experience in CDI.
• Graduate from a Nursing program, BSN, or graduate of Health Information Management (RHIT, RHIA preferred).
• Two years of experience with either HIM/Coding or Case Management.
• Must display teamwork and commitment.
• Demonstrate initiative and discipline in time management and medical record review.
• CDI Subject Matter Expert with advanced knowledge of Medicare Part A and familiarity with Medicare Part B.
• Intermediate knowledge of disease pathophysiology and drug utilization.
• Intermediate knowledge of MS-DRG classification and reimbursement structures.
• Critical thinking, problem solving, and deductive reasoning skills.
• Effective written and verbal communication skills.
• Knowledge of coding compliance and regulatory standards.
• Excellent organizational skills.

Nice To Haves

• CDIP or CCDS certification.

Responsibilities

• Completes initial medical records reviews of patient records within 24-48 hours of admission for a specified patient population.
• Evaluates documentation to assign the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate MS-DRG assignment.
• Initiates a review worksheet and conducts follow-up reviews of patients every 2-3 days to support MS-DRG assignment upon patient discharge.
• Formulates physician queries regarding missing, unclear, or conflicting health record documentation.
• Collaborates with case managers, nursing staff, and other ancillary staff regarding documentation and resolves physician queries prior to discharge.
• Provides daily support, mentoring, and training to new hires and existing staff.
• Assists in managing escalated issues and special projects as needed.
• Performs concurrent and retrospective CDI audits.
• Completes scrubbing and submits monthly data to vendor.
• Enters facility specific data to dashboards.
• Resolves problems and reports issues with Operations Supervisor, Manager, or Director.
• Stays current with AHA Official Coding and Reporting Guidelines, CMS, and other agency directives.
• Attends mandatory coding seminars and quarterly coding updates.
• Communicates and completes Clinical Documentation Improvement (CDI) activities and coding issues.

Benefits

• Medical, dental, vision, disability, life, and business travel insurance.
• Paid time off (vacation & sick leave) - minimum of 12 days per year.
• 401k with up to 6% employer match.
• 10 paid holidays per year.
• Health savings accounts, healthcare & dependent flexible spending accounts.
• Employee Assistance program, Employee discount program.
• Voluntary benefits including pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
• Paid leave in accordance with Colorado's Healthy Families and Workplaces Act for Colorado employees.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree