Cdi Coder Jobs (NOW HIRING)

Position Summary The CDI Validation Team Lead assists the CDI Manager with oversight, evaluation, and analysis of CDI functions including efficiency, accuracy, continuing education needs, and overall quality. This individual identifies individual education needs of Clinical Documentation Specialists and collaborates with the CDI Manager, IP Coding Manager, and IP Coding Validation Manager to develop appropriate training materials. The primary goal is to ensure documentation identifies all clinical findings, diagnoses, and procedures and is appropriately and clinically supported.

The CDI Validation Team Lead works with the CDI Manager to leverage performance, providing feedback and influencing continual improvement of documentation results, thereby impacting key performance indicators. Essential Responsibilities and Duties Monitors CDI staff accuracy, data quality and integrity. Monitors CDS review process for content, timeliness, and accurate diagnosis and procedure assignment in determining a working DRG.

Monitors concurrent queries for compliance, accuracy, clarity, and timeliness. Audits Clinical Documentation Specialists retrospectively to assess chart review completion and query compliance, including missed query opportunities, accurate coding, and adherence to AHIMA/ACDIS compliant query guidelines/standards. Collaborates with the CDI manager to identify, coordinate, and implement CDI specialist ongoing education and feedback based on identified opportunities for improvement through auditing.

Assists in orientation and training of new Clinical Documentation Specialists. Reviews and analyzes denial claims and denial data to support denial prevention strategies via the clinical validation query process and education to CDI specialists. Contributes to departmental and organizational quality performance goals, including auditing mortality and readmission cohorts to identify opportunities for improvement.

Coordinates and implements CDI specialist education based on identified opportunities. Collaborates with the CDI manager to create and update documentation tools, processes, procedures, and workflows on an ongoing and as-needed basis. Reviews charts concurrently with no MCC/CCs, low SOI/ROMs and LOS not supported by working DRG.

Identifies and educates CDI specialists on missed query opportunities. Assists CDI manager with final DRG validation when there is a discrepancy between CDS and coder. Collaborates with the CDI Manager and other CDI department managers to identify areas for improvement and solutions for process improvement.

Assures documentation is compliant with federal and state regulations, coding guidelines and hospital policies. Stays up-to-date in clinical and coding/documentation-related materials, including CDS best practices as defined by ACDIS, ICD-10-CM/PCS, AHA Coding Clinic guidelines, and MS-DRG/APR-DRG classification systems. Monitors regulatory and reimbursement changes and serves as a resource for CDI informational needs, updating CDI on coding changes, medical science and CDI practice standards.

Provides guidance, support and expertise to CDI specialists and tracks trends in documentation concerns, implementing solutions for improvement. Uses leadership and critical thinking skills to identify opportunities for team processes and engagement, recommend solutions for improvement when deficiencies are identified. Provides clinical feedback to CDI specialists, coders, and coding validation specialists to assist in accurately capturing diagnoses and querying physicians post discharge for additional information.

Evaluates the success of concurrent documentation improvement on an ongoing basis. Assists the manager, when requested, in the development of APR/DRG/query response physician reports. Maintains complete confidentiality of patient information in addition to hospital and individual physician practice pattern data.

Assumes operational oversight of the CDI department in the absence of the CDI Manager. Adheres to all BMC's RESPECT behavioral standards. Job Requirements – Education and Experience Bachelor's degree (or equivalent) in nursing, health information management or related field and at least five (5) years of experience in clinical documentation, or an equivalent combination of education and experience, required.

Preferred Education and Experience Master's degree preferred. Certificates, Licenses, Registrations – Required Licensed RN. Certificates, Licenses, Registrations – Preferred CCDS, CDIP.

Knowledge, Skills & Abilities (KSAs) • Demonstrates advanced knowledge of clinical documentation integrity practices, policies, workflows, and analysis. • Strong critical thinking, analytical and problem solving skills. • Highly organized with strong project/task management skills.

• Knowledge of federal, state and payer specific regulations, policies and guidelines pertaining to coding (inpatient or outpatient), documentation requirements and billing. • Experience with 3M Encoder/Grouper and SMART software preferred. • Knowledge of care delivery documentation systems and related medical record documents.

• Knowledge of age‐specific needs and the elements of disease processes and related procedures. • Strong broad‐based clinical knowledge and understanding of pathology/physiology of disease processes. • Excellent written and verbal communication skills.

• Demonstrated ability to maintain positive relationships with employees and medical staff. • Working knowledge of inpatient admission criteria and Medicare reimbursement system. • Familiarity with physician practices, health information, case management or related healthcare discipline and all government health care reimbursement systems.

• Ability to adapt to changes in workload, work independently, and prioritize assignments. • Proficient with standard Microsoft programs (MS Word, Excel, PowerPoint, Outlook) and web browsers. • Ability to analyze large amounts of data to identify trends and provide direction and development to employees through coaching and training.

Compensation Range $89,500.00 – $130,000.00. This range is based on the minimum job qualifications and includes education, experience, skills and certifications. Additional factors such as internal equity and market competitiveness are considered.

Benefits • Medical, dental, vision, and pharmacy coverage. • Discretionary annual bonuses and merit increases. • Flexible Spending Accounts and 403(b) savings matches.

• Paid time off, career advancement opportunities and resources to support employee and family well‐being. Equal Employment Opportunity Statement Boston Medical Center is an equal employment/affirmative action employer. We ensure equal employment opportunities for all, without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression, or any other non‐job‐related characteristic.

If you need accommodation for any part of the application process because of a medical condition or disability, please let us know. #J-18808-Ljbffr