CDI Specialist III

WVU Medicine•Home Work - KY (Remote), KY

About The Position

Responsible for strategic management of service line integration throughout the system. Performs focused and second-level reviews independently at the highest level of expectation and assists the CDI Manager with assigned projects. The role supports planning, execution, and delivery of a high-quality CDI department; system CDI program data collection and reporting; provider education; documentation integrity; regulatory compliance; and accurate reporting of hospital and provider outcomes. The specialist serves as a system service line expert and mentors Level I and II CDI Specialists.

Requirements

Hold one of the following certifications: Certified Documentation Integrity Practitioner (CDIP) through AHIMA; Certified Clinical Documentation Specialist (CCDS) through ACDIS; or Certified Documentation Expert Inpatient (CDEI) through AAPC.
Have three years of inpatient acute care coding experience, or three years of clinical RN experience in an inpatient acute care setting, or three years of clinical LPN experience in an inpatient acute care setting.
Have five years of experience in Clinical Documentation Integrity.
Possess excellent written, verbal, and interpersonal communication skills.
Have knowledge of provider healthcare compliance, revenue cycle operations, and auditing techniques.
Be able to accept mentoring, education, and training from others.
Meet quality and productivity standards.
Be able to concentrate and maintain accuracy during constant interruptions.
Be able to prioritize job duties and adapt to workplace and assignment changes.
Have organizational and time-management skills.
Have knowledge of anatomy, physiology, and medical terminology.
Have analytical and problem-solving skills.
Be proficient in office software programs.
Be able to work independently with minimal supervision.
Be able to sit for long periods, have visual and hearing acuity within the normal range, and have the manual dexterity needed to operate computer and office equipment.

Responsibilities

Assist the CDI Manager in planning, executing, and delivering a high-quality CDI department.
Assist the CDI Manager with designing, collecting, and reporting data to support the System CDI Program.
Collaborate with the CDI Educator/Manager to provide provider education.
Integrate and strategically manage the assigned system service line, keeping the team focused on CDI impact.
Attend revenue integrity meetings related to the designated system service line.
Conduct efficient focused DRG and second-level reviews and deliver timely results.
Work with providers and staff to identify and record principal and secondary diagnoses and procedures, and assign a working DRG.
Conduct initial concurrent reviews and ongoing re-reviews of selected admissions, documenting findings related to DRGs, APR-DRGs, and Value Based Purchasing/Quality measures.
Identify documentation clarification needs through record quality audits and initiate communication with physicians, nurses, or patient care coordinators using appropriate query tools.
Provide providers and staff with information and ongoing education on documentation issues, guidelines, and unanswered queries.
Promote compliance with CMS and Medicare documentation, coding, and billing regulations.
Participate in assessing and improving services and regulatory compliance, and report assessment and improvement results to appropriate administrative levels.
Collaborate with the Quality Department to ensure documentation meets standards for measuring and reporting hospital and provider outcomes.
Collect, analyze, and submit timely, accurate, and complete clinical documentation reports used to measure and report hospital and provider outcomes.
Work with Coding Specialists to resolve documentation, provider, and query issues and enhance the concurrent process for prompt coding.
Mentor and advise Level I and II CDI Specialists.