CDI Auditor - PRN - Remote

Clinical Documentation Improvement - Auditor - PRN as needed - REMOTE

JOB SUMMARY:

The Clinical Documentation Integrity Quality Auditor is responsible for completing quality assurance reviews of patient medical records to ensure accurate and complete documentation to reflect the patient’s severity and complexity of illness. The Clinical Documentation Integrity Quality Auditor will audit records previously reviewed by Customer CDS consultants. The chart will be reviewed for missed opportunities to capture greater specificity or clarify inconsistencies in the clinical picture of the patient. Queries posed by the Customer CDS will be reviewed from a compliance perspective, utilizing ACDIS/AHIMA Practice Brief (2022) as the standard. Adherence to Customer specific CDI processes or procedures may also be reviewed. The Validation Consultant may also review accounts not previously reviewed by Customer CDS to identify opportunities for improvement. The Validation Consultant will work within Customer systems and e4health Audit software to identify areas of risk, documentation opportunities, identifiable trends, and assist with report writing as appropriate. This position is expected to interact with the Customer appropriately and other team members.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

· Review medical records as assigned for complete and accurate documentation of all relevant diagnoses and procedures

· Identify missed documentation opportunities within medical records as previously reviewed or not reviewed by Customer CDI team

· Evaluate queries from a compliance perspective to determine if there are any areas of risk, using ACDIS/AHIMA Practice Brief as the standard

· Assess adherence to Customer specific CDI processes/procedures

· Adhere to guidelines as set forth by ACDIS, AAPC, and AHIMA

· Demonstrate understanding of the business of healthcare: MS and APR DRG payer issues, audit risks, documentation opportunities, POA, quality metrics, hierarchical condition categories, and various risk adjustment methodologies

· Work closely with the Customer, co-workers, and management to meet the specific needs of each assignment in alignment with core values

· Effectively utilize computer software based on the specific Customer requirements

· Maintain strict confidentiality of all patient information in accordance with HIPAA

REQUIRED QUALIFICATIONS:

· Candidate must possess current ACDIS CCDS or AHIMA CDIP certification

· 5+ years of clinical documentation experience required with an acute care facility required

· 2+ years of CDI auditing experience

· Current RN license or graduate of medical school with 5+ years of acute care experience preferred; some Customers may require RN

· Minimum 2 years of remote experience required

· Thorough understanding of both MS and APR DRG methodologies and Compliant Query Practices as outlined by ACDIS/AHIMA

· Strong analytical skills to clinically evaluate the medical record

· Ability to independently use multiple computer applications for medical record review along with proficiency utilizing Microsoft products (Excel, Word, Outlook)

· Ability to communicate effectively with e4health management and Customers

· Proficiency with ICD-10-CM and ICD-10-PCS

PREFERRED QUALIFICATIONS:

· Coding credentials such as CCS is preferred

· BSN, in addition to RN license is preferred

· Experience with multiple health facilities, multiple electronic medical records, and multiple encoders strongly preferred

· Familiarity with various risk models strongly preferred

· Understand of HAC/PSI models, including exclusionary opportunity is preferred

KEY SUCCESS ATTRIBUTES: 

· Integrity, passion, and ethics are required

· Demonstrates strong collaboration skills

· Has strong analytic and problem-solving abilities and techniques

· Exhibit consistent initiative with strong drive for results and success

· Demonstrate commitment to a team environment 

· Well-developed written, verbal, and presentation communication skills including deep listening and attention to detail

· Ability to self-motivate and self-direct

· Possess strong time management and organizational skills

· Commitment and adherence to company Core Values

CORE COMPETENCIES:

· High level of integrity & ethical judgement

· Communication

· Consistency and Reliability

· Meeting Standards

BENEFITS:

We offer an excellent salary, full benefits package including 401(k) with company match, medical, dental, vision, life, short/long term disability insurance, and PTO policy.

PHYSICAL DEMANDS OF THE ESSENTIAL FUNCTIONS:

Sitting, talking, hearing and near vision are required over 90% of the time. Feeling is required over 90% of the time and reaching is required about 50% of the time. The ability to travel to field sites may be required up to 15% of the time.

WORKING CONDITIONS WHILE PERFORMING ESSENTIAL FUNCTIONS:

Over 90% of the time is spent indoors, with protection from weather conditions. Exposure to noise levels that may be distracting or uncomfortable is present in only unusual situations.

e4health is an equal opportunity employer and will consider all applications without regard to race, color, religion, national origin, ancestry, marital status, veteran status, age, disability, pregnancy, genetic information, gender, sexual orientation, gender identity or any other legally protected category.

Applicants for U.S. based positions with e4health must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Visa sponsorship is not available for this position.

Job Types: Part-time, Contract, Temporary

Pay: From $45.00 per hour

Benefits:

• Flexible schedule

Healthcare setting:

• Acute care
• Hospital
• Inpatient

Schedule:

• Choose your own hours
• Weekends as needed

Application Question(s):

• Are you either a US citizen or an alien lawfully authorized to work in the US?
• Do you now or will you at any time in the future require sponsorship?
• Can you work on an as needed basis only, PER DIEM (PRN) schedule for special projects?

Experience:

• CDI Auditing: 2 years (Required)
• CDI: 5 years (Required)

License/Certification:

• ACDIS CCDS or AHIMA CDIP credential (Required)
• RN License (Required)

Work Location: Remote