CDI Quality Reviewer

🔥 0 minutes ago

🤠 Texas – Remote

🤠 Texas – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

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👻 Ghost score 10%

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Memorial Hermann Health System

WebsiteLinkedInAll Job Openings

10,000+ employees

⚕️ Healthcare Insurance

🏥 Healthcare

🧘 Wellness

💰 $5M Grant on 2022-08

Healthcare Insurance • Healthcare • Wellness

Memorial Hermann Health System is a comprehensive healthcare organization that provides a wide range of medical services, including cancer care, cardiovascular services, emergency and trauma care, women’s health, and surgical services. With the largest network of emergency centers in Greater Houston, it focuses on delivering advanced healthcare and wellness programs tailored to individual needs. Memorial Hermann is committed to advancing health equity and enhancing community health through its various medical facilities and services.

📋 Description

• Conduct comprehensive secondary clinical chart reviews for targeted patient populations • Identify missed opportunities for documentation clarification and clinical validation • Review DRG and code discrepancies, mortality reviews, HACs, PSIs and priority diagnoses • Analyze clinical data to identify documentation gaps, inconsistencies and improvement opportunities • Query providers using the concurrent query process and ACDIS/AHIMA compliant query guidelines • Liaise between Coding and Clinical Documentation Integrity to reconcile code and DRG discrepancies • Communicate secondary review findings and track review results for the Manager • Collaborate with CDI Educator/Auditor to address educational needs • Research and remain current on clinical and coding guidelines, including quarterly Coding Clinics and ICD-10 • Support the quality, timeliness and completeness of health records • Collaborate with physicians and clinicians to improve CDI program understanding and documentation quality • Ensure records accurately reflect patient severity of illness and risk of mortality • Adhere to Memorial Hermann policies, procedures, safety standards, productivity and quality expectations • Support department goals and serve as a resource to less experienced staff • Perform other duties as assigned

🎯 Requirements

• Bachelor’s of Nursing, required • Current State of Texas license or temporary/compact license to practice professional nursing • One of the following required: Certified Clinical Documentation Specialist (CCDS), Certified Clinical Documentation Integrity Professional (CDIP), or Certified Coding Specialist (CCS) • Three (3) years of Clinical Documentation Integrity (CDI) experience required • Strong computer proficiency, including MS Office—Word, Excel and Outlook—and 3M Coding and Reimbursement software • Excellent communication, analytical and problem-solving skills • Strong organizational skills and attention to detail • Strong risk assessment, impact analysis and problem-solving skills • Ability to work independently, take direction and be a team player • Flexibility, multitasking and ability to prioritize daily workload • Master’s Degree in Nursing or Management preferred • Approved AHIMA ICD-10-CM/PCS Trainer preferred • Previous CDIS auditing, denial and Vizient experience preferred • Experience with Epic EMR preferred • Must have CDI experience to be considered

🏖️ Benefits

• Mandatory/continuing education and skills competency support • Professional growth and development opportunities • Supportive employee-focused workplace culture • Compassionate and personalized experiences for employees and community members