Clinical Documentation Integrity, Second Level Reviewer

Job not on LinkedIn

🕒 January 27

🐊 Florida – Remote

🐊 Florida – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥📝 Medical Writer

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University of Miami

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1925

📚 Education

💰 $1M Grant on 2023-02

Education

University of Miami is a prestigious private research university located in Coral Gables, Florida. It offers a wide range of undergraduate, graduate, and professional degree programs through its numerous schools and colleges, including the School of Architecture, College of Arts and Sciences, and Miami Herbert Business School among others. The university is recognized for its contributions to research, particularly in areas such as marine and atmospheric science through the Rosenstiel School, as well as in medicine through the Miller School of Medicine. The institution is also noted for its vibrant student life, with a strong emphasis on athletics and community engagement. University of Miami is committed to fostering an inclusive educational environment and is home to a diverse student body from around the globe.

📋 Description

• Perform high-level, complex, secondary case reviews to facilitate and obtain appropriate provider documentation for clinical conditions or procedures • Ensure accuracy, completeness, and quality of clinical information used for measuring and reporting physician and hospital outcomes • Perform secondary case reviews to identify potential gaps or opportunities to facilitate improved provider documentation • Ensure clinical documentation accurately reflects the level of care rendered, severity of illness, risk of mortality, and clinical validation • Apply advanced knowledge of CMS star rating, Vizient, and US News and World Report risk-adjustment systems to identify clinical documentation improvement opportunities • Complete quality reviews focused on CDI quality elements, such as Mortality, Hospital Acquired Conditions (HAC), and other publicly reported patient quality or safety metrics • Identify trends and key areas for improvement in querying, coding, and documentation integrity • Demonstrate proficiency with ICD-10-CM/PCS, APR DRG, and MS DRG • Communicate and collaborate effectively with providers, HIM/coding, quality, CDI, and other members of the healthcare team

🎯 Requirements

• Four (4) Year/bachelor’s degree required • BSN/BS/BA in related field Required • Graduate degree in Healthcare Administration, Informatics, Nursing, Leadership, Education or related field preferred • Current RN or MD required • CCDS or CDIP certification required • Coding certification (CCS, CIC, or CPC) preferred • At least three (3) years recent inpatient clinical documentation improvement (CDI) experience required • Demonstrated extensive clinical knowledge • At least three (3) years of direct patient care clinical experience in hospital setting preferred • Proficiency with ICD-10-CM/PCS, APR DRG, and MS DRG required • At least one (1) year experience with mortality, PSI, HAC, or other quality-focused reviews required • Knowledge of Vizient, Premier, US News and World Report, CMS star rating or similar risk-adjustment methodologies highly preferred • Prior experience in an academic medical center (AMC) or large health system preferred • Proficiency with Microsoft Office (Excel, PowerPoint, Word, Outlook) required • Proficiency with CDI software and encoder required • Experience with 3M 360 Encompass preferred

🏖️ Benefits

• medical • dental • tuition remission • competitive salaries