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CDI RN Specialist

Company: Tenet
Location: Grand Island
Posted on: October 9, 2019

Job Description:

As a part of the Tenet andCatholic Health Initiatives family, Conifer Health brings 30 years ofhealthcare industry expertise to clients in more than 135 local regionsnationwide. We help our clients strengthen their financial and clinicalperformance, serve their communities and succeed at the business of healthcare.Conifer Health helps organizations transition from volume to value-based care,enhance the consumer and patient healthcare experience and improve quality,cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you theresources and incentives to redefine healthcare services, with a competitivebenefits package and leadership to take your career to the next step! JOB SUMMARYResponsible for reviewing medical records to facilitate andobtain appropriate physician documentation for any clinical conditions orprocedures to support the appropriate severity of illness, expected risk ofmortality, and complexity of care of the patient, by improving the quality ofthe physicians? clinical documentation. Exhibits a sufficient knowledge of clinical documentation requirements,MS-DRG Assignment, and clinical conditions or procedures, Educates members of the patient care teamregarding documentation guidelines, including attending physicians, alliedhealth practitioners, nursing, and case management. ESSENTIAL DUTIES ANDRESPONSIBILITIESInclude thefollowing. Others may be assigned.

  • Record Review: Completes initial medical records reviews ofpatient records within 24-48 hours of admission for a specified patientpopulation to: (a) evaluate documentation to assign the principal diagnosis,pertinent secondary diagnoses, and procedures for accurate MS-DRG assignment,risk of mortality and severity of illness; and (b) initiate a reviewworksheet. Conducts follow-up reviewsof patients every 2-3 days to support and assign a working or final MS-DRGassignment upon patient discharge, as necessary. Formulate physician queriesregarding missing, unclear or conflicting health record documentation byrequesting and obtaining additional documentation within the health record, asnecessary. Collaborates with case managers, nursing staff and other ancillarystaff regarding interaction with physicians regarding documentation and toresolve physician queries prior to discharge.
  • Assist in training department staff newto CDI
  • Professional Development: Stays current with AHA Official Coding andReporting Guidelines, CMS and other agency directives for ICD-9-CM and CPTcoding. Attends mandatory codingseminars on annual basis (IPPS and OPPS, ICD-9-CM and CPT updates) forinpatient and outpatient coding. Quarterlyreview of AHA Coding Clinic. AttendsQuarterly Coding Updates and all coding conference calls as well as anyrequired CDI education.
  • CDI: Communicates/Completes Clinical Documentation Improvement (CDI)activities and coding issues (lacking documentation, physician queries, etc.)for appropriate follow-up and resolution
  • Other duties as assigned

    Qualifications:
    KNOWLEDGE, SKILLS,ABILITIESTo perform this jobsuccessfully, an individual must be able to perform each essential dutysatisfactorily. The requirements listed below are representative of theknowledge, skill and/or ability required. Reasonable accommodations may be madeto enable individuals with disabilities to perform the essential functions.
    • CDI Specialist must display teamwork andcommitment while performing daily duties
    • Must demonstrate initiative anddiscipline in time management and medical record review
    • Travel may be required to meet the needsof the facilities
    • Advanced knowledge of Medicare Part Aand familiar with Medicare Part B
    • Intermediate knowledge of diseasepathophysiology and drug utilization
    • Intermediate knowledge of MS-DRGclassification and reimbursement structures
    • Critical thinking, problem solving anddeductive reasoning skills
    • Effective written and verbalcommunication skills
    • Knowledge of coding compliance andregulatory standards
    • Excellent organizational skills forinitiation and maintenance of efficient work flow
    • Regular and reliable attendance and timereporting per Conifer Telecommuting program requirements
    • Capacity to work independently in avirtual office setting or at facility setting if required to travel forassignment
    • Understand and communicate documentationstrategies
    • Recognize opportunities fordocumentation improvement
    • Formulate clinically, compliant crediblequeries
    • Ability to maintain an auditing andmonitoring program as a means to measure query process
    • Ability to apply coding conventions,official guidelines, and Coding Clinic advice to health record documentationEDUCATION /EXPERIENCEInclude minimumeducation, technical training, and/or experience required to perform the job.
      • Preferred: Acute Care nursing relevant experience
      • Zero (0) to two (2) years of experience
      • Graduate from a Nursing program, BSN, orgraduateCERTIFICATES,LICENSES, REGISTRATIONS
        • Active state Registered Nurse license
        • Preferred: CDIP or CCDSPHYSICAL DEMANDS The physical demandsdescribed here are representative of those that must be met by an employee tosuccessfully perform the essential functions of this job. Reasonableaccommodations may be made to enable individuals with disabilities to performthe essential functions.
          • Ability to sit for extended periods oftime
          • Must be able to efficiently use computerkeyboard and mouse
          • Good visual acuityOTHER
            • Must be able to travel nationally asneeded, not to exceed 10%Job: Conifer Health SolutionsPrimary Location: Grand Island, NebraskaJob Type: Full-timeShift Type: Days

Keywords: Tenet, Grand Island , CDI RN Specialist, Healthcare , Grand Island, Nebraska

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