Clinical Documentation Integrity Specialist - Remote CDI Expert with Comprehensive Patient Care Focus

Join Our Team as a Clinical Documentation Integrity Specialist and Elevate Patient Care Are you a dedicated and detail-oriented healthcare professional looking for a new challenge? Do you have a passion for ensuring accurate and comprehensive patient care? Guidehouse is seeking a highly skilled Clinical Documentation Integrity (CDI) Specialist to join our team remotely. As a CDI Specialist, you will play a critical role in reviewing and analyzing health records to identify opportunities to clarify relevant diagnoses and procedures for distinct patient encounters. This is a unique opportunity to work collaboratively with providers, other healthcare professionals, and the coding team to ensure that clinical information in the medical record is present and accurate. About Guidehouse and Our Commitment to Patient Care Guidehouse is a leading provider of healthcare consulting services, dedicated to improving patient outcomes and enhancing the quality of care. Our team of experts works closely with healthcare organizations to optimize clinical documentation, coding, and reimbursement processes. We are committed to creating a diverse and supportive workplace that reflects our values of compassion, integrity, and excellence.

Key Responsibilities

As a Clinical Documentation Integrity Specialist, your primary responsibilities will include:

• Conducting comprehensive initial and follow-up concurrent reviews of medical records for assigned patients
• Identifying opportunities to clarify incomplete or conflicting documentation and/or to validate diagnosis in the medical record
• Preparing compliant written queries for responsible treating physicians, following the most current ACDIS/AHIMA Guidelines to Achieving a Compliant Query Process
• Assigning working MS-DRG, secondary diagnoses, and significant procedures
• Establishing a working DRG and updating DRG based on record documentation during concurrent reviews
• Utilizing the appropriate UAB query template and following 2022 ACDIS/AHIMA Guidelines to Achieving a Compliant Query Process
• Ensuring relevant and/or approved clinical indicators specific to the patient and the clinical record are cited on the query template
• Tracking physician query response documented in the medical record
• Maintaining productivity and established performance benchmarks for quality

Essential Qualifications

To be successful in this role, you will need:

• At least one of the following: RN, MD, or MD Equivalent (MBBS)
• At least 2-4 years of acute care inpatient hospital coding or CDI experience
• Familiarity with encoder and DRG assignment
• Current working knowledge of official coding guidelines and coding clinics

Preferred Qualifications

We would also prefer candidates with:

• CCDS, CDIP certification
• Strong clinical understanding of disease processes
• Demonstrated critical thinking, analytical skills, and ability to resolve problems
• Strong knowledge of medical terminology, anatomy, physiology, microbiology, and disease processes
• Excellent communication skills, employing tact and effectiveness
• Ability to converse with physicians in sometimes difficult scenarios
• Strong typing and computer skills; proficiency with EHR systems, CDI software systems, and encoders

Career Growth

Opportunities and Learning Benefits At Guidehouse, we are committed to the growth and development of our employees. As a CDI Specialist, you will have access to:

• Comprehensive training and onboarding program
• Ongoing education and training opportunities
• Professional development and certification support
• Opportunities for career advancement and growth

Work Environment and Company Culture

We offer a dynamic and supportive work environment that values:

• Diversity and inclusion
• Collaboration and teamwork
• Innovation and creativity
• Employee recognition and rewards

Compensation, Perks, and Benefits

We offer a comprehensive total rewards package, including:

• Competitive salary range of $61,000 - $101,000 per year
• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
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