CDI Senior Specialist - Lakewood, CA - Hybrid

Conifer Revenue Cycle Solutions • Long Beach, CA

273d • $77,258 - $115,899

About The Position

Responsible for reviewing medical records to facilitate and obtain appropriate physician documentation for any clinical conditions or procedures to support the appropriate severity of illness, expected risk of mortality, and complexity of care of the patient, by improving the quality of the physicians' clinical documentation. Exhibits a sufficient knowledge of clinical documentation requirements, MS-DRG Assignment, and clinical conditions or procedures, educates members of the patient care team regarding documentation guidelines, including attending physicians, allied health practitioners, nursing, and case management.

Requirements

• Graduate from a Health Information Management RHIT, RHIA, nursing degree and/or bachelor's degree.
• Two (2) or more years relevant experience.
• Advanced knowledge of Medicare Part A and familiar 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 for initiation and maintenance of efficient work flow.
• Capacity to work independently in a virtual office setting or at facility setting if required to travel for assignment.

Nice To Haves

• RHIT, RHIA, LPN, MD, AAPC, and/or CCS.
• CDIP or CCDS.

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, risk of mortality and severity of illness.
• Initiates a review worksheet.
• Conducts follow-up reviews of patients every 2-3 days to support and assign a working or final 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 interaction with physicians regarding documentation.
• Assists in training department staff new to CDI.
• Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-9-CM and CPT coding.
• Attends mandatory coding seminars on annual basis for inpatient and outpatient coding.
• Communicates/Completes Clinical Documentation Improvement (CDI) activities and coding issues for appropriate follow-up and resolution.

Benefits

• Medical, dental, vision, disability, and life insurance.
• Paid time off (vacation & sick leave) - min 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 include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.

What This Job Offers

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