Clinical Documentation Integrity Specialist – Inpatient

🔥 7 minutes ago

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The University of Kansas Health System

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1998

⚕️ Healthcare Insurance

📚 Education

🤝 Non-profit

Healthcare Insurance • Education • Non-profit

The University of Kansas Health System is a comprehensive healthcare provider that partners with the University of Kansas Medical Center to offer top-tier medical services and education. It is recognized for its excellence in patient care, research, and education, with services ranging from urgent care to specialized cancer treatment at its NCI-designated cancer center. As a nonprofit organization, it relies on donations to provide high-quality healthcare to the community. Additionally, it offers a variety of educational opportunities through residency programs and fellowships, and emphasizes the importance of wellness and holistic health management for patients and professionals alike.

📋 Description

• Review inpatient medical records to ensure completeness and accuracy for severity of illness and risk of mortality. • Ensure effective communication with healthcare staff to suggest additional documentation. • Work closely with HIM coding staff to confirm discharge diagnoses and co-morbidities are accurately reflected. • Conduct concurrent review of medical records and document findings on CDS worksheets. • Identify principal and secondary diagnoses, procedures, and quality indicators. • Clarify documentation as needed and facilitate accurate patient records. • Use monitoring tools to track program progress and share findings. • Educate staff on documentation improvement and facilitate compliance. • Engage with healthcare team to improve clinical documentation processes.

🎯 Requirements

• Associates Degree in Health Information Management or a related field from an accredited college or university. • Certification in RHIT or RHIA along with CCDS or CDIP. • For Nurses: Associate degree and 3 or more years of experience in an acute care setting. • All other clinical disciplines: Associate degree in respective fields of study from an accredited college or university. • Foreign medical graduate (MD) along with CDI certification of CCDS and/or CDIP in lieu of Kansas RN license is acceptable. • 3 or more years of experience in Clinical Documentation, Case Management/Utilization Review, or Critical Care. • Licensed Registered Nurse (LRN) - Single State or Multi-State - State Board of Nursing. • Must have certification of CCDS or CDIP or foreign medical graduate (MD) with CDI certification.

🏖️ Benefits

• The health system is an equal employment opportunity employer. • Provides reasonable accommodations to qualified individuals with disabilities.