About the job
UW MEDICAL CENTER – MONTLAKE has an outstanding opportunity for a Second Level Review Clinical Documentation Integrity Specialist (RN)!
WORK SCHEDULE
- Full-time day shift. The work is fully remote.
POSITION HIGHLIGHTS
Following established policies, procedures, and professional guidelines, the Second Level Review Clinical Documentation Integrity Specialist (SLR CDIS) provides industry expertise on focused accounts that are set by the direction of CDP leadership to ensure high quality standards are met for risk adjustment, DRG accuracy, SOI and ROM.
DEPARTMENT DESCRIPTION
The Clinical Documentation Integrity Program (CDIP) performs concurrent review of inpatient medical records to ensure provider documentation accurately reflects patient severity of illness (SOI), acuity of care needs, risk of mortality (ROM) and the quality of treatment provided. Team members also serve on various multidisciplinary committees promoting quality improvement and patient safety initiatives.
PRIMARY JOB RESPONSIBILITIES
- Reviews target DRGs specified by CDP Manager, which is an evolving workflow. This review may focus various elements including, but not limited to, CC/MCC capture rate and/or risk adjustment review and will be clarified by DRG.
- Ensures that pertinent patient conditions and treatments are documented such that appropriate reimbursement is received for the level of acuity and service rendered to all patients using a DRG based payer (Medicare) methodology.
- Verifies the accuracy and completeness of clinical information used for measuring and reporting outcomes related to patient care, physician practice and the medical center performance.
- Participates in various projects and initiatives within the Clinical Documentation Program. Based on findings, department goals and initiatives and industry expectation, the SLR CDIS will participate in the education and evaluation of the CDI team.
- Collaborate with medical records coding staff, patient financial services (PFS) and compliance for Clinical Validation Denial appeals.
REQUIREMENTS
Please apply only if you meet the listed requirements below.
- Current WA RN License or compact RN license
- Minimum of 6 years of nursing experience to an acute inpatient hospital setting with in-depth knowledge of medical and surgical care. ER or ICU experience preferred.
- Minimum of 5 years of experience in Clinical Documentation Improvement role.
- Risk adjustment experience required (Vizient and Elixhauser preferred)
- Current Certification in CDI (CCDS, CDIP or CCS)
Become part of our team. Join our mission to make life healthier for everyone in our community.
EO/AAE