Revenue Cycle CDI Specialist

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.

Job Summary / Purpose
Responsible for reviewing medical records to facilitate and obtain appropriate provider documentation for clinical conditions and/or procedures to support the appropriate DRG assignment, severity of illness, expected risk of mortality, and complexity of care of the patient, by improving the quality of the providers' clinical documentation. The CDS exhibits clinical expertise and clinical documentation improvement practices, as well as knowledge of compliant coding practices, adherence to AHIMA/ACDIS Guidelines for Achieving a Compliant Query Practice. Acts as a liaison between providers, clinical quality, patient financial services, etc. to ensure collaborative relationships resulting in accuracy and integrity of the inpatient medical record. Educates members of the patient care team regarding documentation guidelines, including attending providers, allied health practitioners, nursing, quality and case management.

Essential Functions
Essential Function

• Completes initial medical records reviews within 24-48 hours of admission for a specified patient population to evaluate documentation to assign the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate DRG assignment, risk of mortality and severity of illness
• Conducts follow-up reviews every 2-3 days to support working DRG assignment
• Formulates compliant provider queries regarding missing, unclear or conflicting documentation, as necessary
• Follows up daily on open queries with providers to ensure timely responses
• Reviews final coding DRG assignment follows DRG reconciliation process
• Keep abreast of Official Coding and Reporting Guidelines, AHA Coding Clinics, CMS and other agency directives and maintains up to date knowledge of coding and CDI current trends
• Strong oral communication skills and the ability to deliver presentations to large groups
• Actively seeks to promote and helps to maintain a professional, team-oriented, service-conscious environment, which contributes to the goals of the team and reflects the values of the enterprise
• Proactively develops a collaborative relationship with the HIM Coding Professionals
• Collaborates with leadership when needed, per the escalation process, to resolve provider issues regarding answering clarifications and participation in the clinical documentation improvement process
• Ability to troubleshoot computer issues in a timely fashion while working remotely

Education and Experience

Bachelors Of Nursing and/or Bachelor’s degree in Nursing, or HIM

CAC experience (Computer Assistant Coding), Preferred

2 years’ acute care hospital clinical CDI experience 

2 years’ experience inpatient coding auditor

Experience with various encoder and EMR systems (Optum eCAC, Solventum, EPIC, Cerner, Meditech)

Licensure and Certifications

Registered Health Information Technician (RHIT), Required
Certified Coding Specialist (CCS), Required
Registered Nurse:XX (RN:XX), Required 

Certified Cardiac Device Specialist (CCDS), Preferred
Clinical Documentation Improvement Professional (CDIP), Preferred
Certified Coding Specialist (CCS), Preferred