Clinical Documentation Improvement (Cdi) Consultant

Overview
Good enough isn't for us. Duly Health and Care's team members show up every day driven to exceed expectations. We challenge assumptions and invite dissent to accomplish bold goals and unleash the most extraordinary work of your career. We see and support the remarkable in every person within and beyond the walls of our work. Duly Health and Care works to understand what matters most to you. We recruit and retain team members who share a relentless passion and pride for helping others live happier and healthier lives. We invest in helping our team members develop their talents in a way that is rich in personal meaning. We invite you to join us, fulfill your purpose and make your mark!
Holistic benefits designed to help our team members flourish in all aspects of their lives, including:

• Comprehensive medical and prescription drug benefits that include medical coverage at 100% (after deductible) when utilizing a Duly provider.
• $5,250 Tuition Reimbursement per year.
• 40 hours paid volunteer time off.
• A culture committed to Diversity, Equity, and Inclusion (DEI) and Social Impact.
• 12 Weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members.
• 401(k) Match
• Profit-sharing program

Responsibilities
Are you ready to challenge the expected to deliver the extraordinary?
The CDI Consultant uses clinical knowledge to serve as an advisor to providers and staff regarding complete and accurate documentation supporting services provided in the outpatient and office-based settings. Under the direction of the Risk Adjustment Manager, the CDI Consultant will conduct concurrent reviews of outpatient medical records before the patient is seen as well as work with clinicians concurrently to guide and educate. This position collaborates with providers and coding teams to deliver education on documentation best practices that result in accurate, comprehensive medical record that reflects the diagnoses for the patient and supports patient care and correct reimbursement.
The Journeys and Adventures that Await

• Performs prospective, concurrent and retrospective chart reviews for improving the overall completeness of Clinical Documentation.
  • Assesses content of all Clinical Documentation prior to the patient being seen to identify all chronic conditions and comorbidities
  • Collaborates with physician to identify and clarify missing, conflicting, or nonspecific documentation related to diagnoses and procedures
  • Promotes health record completion during the clinic visit
  • Communicates with clinicians to clarify documentation and query for specificity
  • Monitors verbal and written queries
  • Consistently meets established productivity target for record review
• Acts as a resource for Providers and Coding staff
  • Keeps abreast of current coding trends and maintains up to date knowledge of Medicare rules and regulations regarding diagnosis coding and CDI current trends
  • Effectively utilizes ICD, CPT/HCPCS and related materials to investigate coding issues and produce accurate results.
  • Serves as an expert resource in reviewing all medical records in support of accurate documentation for all payer types to assure complete and accurate diagnosis and procedure capture and coding.
  • Routinely provides physician, advanced practice provider, and other key healthcare providers with education strategies that result in improved Clinical Documentation and complete capture of diagnosis coding.
  • Communicates information effectively by responding to questions, concerns, and requests promptly and encourages open dialogue with providers.
• Supports, monitors, and reports key performance indicators (KPIs) oMonitors trends in the CDI process and develops and implements action plans to maximize the program.
  • Develops and implements CDI strategies, provides analysis and makes recommendation for process improvement.
  • Collaborate with staff within other functional areas (i.e. risk adjusted coding Physician Champions, Compliance Director, Coders)
  • Utilizes software systems to collect and ensure effectiveness of the data to track progress of CDI program such as identification of cases with CDI opportunities, HCC recapture rate, etc.
• Maintains expert knowledge of CDI and ICD-10 Coding
  • Keeps abreast of current changes in coding and reimbursement requirements for government programs and other third-party payers.
  • Reviews Medicare and Commercial payer publications on a frequent basis and develops coding education in a proactive fashion to add value to the overall quality of Clinical Documentation.
  • Actively participates in meetings and/or seminars and disseminates the information to peers to enhance the knowledge and skills of the department.
• Other duties as assigned.

Qualifications
The Experiences You Bring

• Must have specific knowledge of diagnostic and procedural terminology, ICD and CPT/HCPCS coding systems, and billing compliance rules.
• Nursing Associate degree required
• Nursing Bachelor's degree preferred
• RN preferred or strong Coding background in Risk adjustment, Internal Medicine
• Professional certification in Clinical Documentation through AHIMA (CDIP) or ACDIS (CCDS) recommended and must be obtained within 2 years of hire
• Professional Coding certification (CPC, or CCS-P) recommended
• Computer skills, including Microsoft Office suite of products
• Experience in critical care nursing is highly preferred
• Minimum of 3 to 5 years of clinical experience