AUDITOR, CLINICAL DOCUMENTATION
AUDITOR, CLINICAL DOCUMENTATION
Req# 16727CDI & DENIAL PREVENTIONFull time, 1 - Days, Days Position summary : The Clinical Documentation and Coding Integrity Quality Auditor performs clinical documentation validation reviews.
Performs quantitative and qualitative reviews and analysis of the clinical health records and physician queries both concurrently and retrospectively to ensure documentation is accurate, consistent and complete.
Quality Auditor identifies educational opportunities, including discrepancies in clinical indicators and diagnostic statements which impact DRG assignment, severity of illness, risk of mortality and resource utilization.
Quality Auditor is also involved in the clinical denial / appeal process for DRG challenges and clinical validations of both external and internal claims.
The Quality Auditor utilizes analysis of data, dashboards, and audits to assist in identifying gaps, root causes and solutions for clinical documentation specialists and physician leadership.
The Quality Auditor acts as a subject matter expert and resource for the Clinical Documentation Specialists and assumes the role of CDS as demands for services requires.
May perform ther duties as assigned. Job Qualifications : Medical Graduate, Nurse Practitioner or Physician Assistant. Master's degree or Foreign Medical Graduate.
Clinical Documentation Improvement Certification (CCDS or CDIP) and ability to obtain Certified Coding Specialist (CCS) Certification within 1 year of hire.
Minimum of 1 year CDS experience; Leadership skills and demonstrated expertise in clinical documentation improvement / coding.
Skilled educator and communicator. Excellent interpersonal and team building skills,with an ability to collaborate effectively with physicians, nurses and members of the health care team.
Proficient / functional knowledge of electronic medical record systems and information technology. Willingness to learn CDI software is required.
Willingness to maintain flexible work hours, assume other duties as assigned, and provide weekend / holiday coverage as needed.
Preferred Qualifications : 3+ years of CDS experience.
Salary Range : $65.62 - $92.33
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