Lead CDI DRG Auditor
3 weeks ago
JOB DESCRIPTION:
The Lead Clinical Documentation Integrity (CDI) DRG Auditor works under the direction of the Associate Director of CDI Quality and Education. He/she performs all the requirements of the Lead CDI DRG Auditor. In addition, this position is responsible for identifying areas of documentation improvement such as DRG accuracy, compliance, severity of illness, risk of mortality and risk adjustment factors during inpatient medical record review. Audits will be conducted retrospective (post-discharge, pre-bill) once final coding has been completed. The Lead CDI DRG Auditor will:
Perform pre-bill reviews from opportunities identified through internal referrals, organizational initiatives i.e. Physician service lines, data analytics and other various sources.
Utilize an audit tool to enter findings, send feedback, track and trend data to identify areas of opportunity.
Review the results with the Associate Director of CDI Quality and Education and relevant stakeholders.
Work closely with multidisciplinary teams including Coding DRG Auditors and second level physician reviewers to justify all clinically supporting documentation for coding accuracy.
Be a subject matter expert in basic and intermediate CDI and coding concepts.
Work closely with the multidisciplinary team to provide the status of reviews and propose topics for clinical documentation improvement opportunities/education required.
Supports organizational goals by providing quality customer service, participating in performance improvement efforts and demonstrating a strong acumen to teamwork and collaboration.
Other duties as deemed necessary, which may include supporting and managing work outside of focus audits such as quality reviews, educational presentations, and any other business needs or workload demands, or other projects that correlate with the growth/scope of the department.
MINIMUM QUALIFICATIONS:
Graduate of an accredited school of nursing, or United States or International School of Medicine degree.
Must have at least 5 years in healthcare related field with strong clinical expertise and acumen.
Preferred critical care clinical experience.
For RNs, candidates must have an active license.
All nurses employed in the role requiring an unencumbered nursing license must have a valid active license or temporary permit approved by the Georgia Licensing Board.
Education and experience may be considered in lieu of an RN License for qualified candidates (physicians).
Must have active CDI Certification (CDIP or CCDS), the addition of coding Certification (CCS) is required or obtained within six months of hire date.
SALARY RANGE: $33.21-$60.43/HR
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