CDQI Nurse Specialist PRN - Remote

Overview

Who we are...

Ciox Health merged with Datavant in 2021, creating the nation's largest health data ecosystems, powering secure data connectivity on behalf of thousands of providers, payers, health data analytics companies, patient-facing applications, government agencies, research institutions and life science companies. The combined company is focused on improving patient outcomes and reducing costs by removing impediments to the secure exchange of health data. Ciox, a Datavant company will offer the ability to access, exchange, and connect data among the thousands of organizations in its ecosystem for use cases ranging from better clinical care and value-based payments to health analytics and medical research.

What we offer…

At Ciox Health we offer all employees a place to grow and expand their current skills so that they can not only help build Ciox Health into the greatest health technology company but create a career that you can be proud of. We offer you complete training and long-term career goals. Our environment is what most of our employees are the proudest of and our Architecture Group is comprised of some of the brightest and most talented individuals. Give us just a few moments to explain why we need you and hope you will help us change how the health Industry manages its’ medical records.

What we need…

Job purpose:

The Clinical Documentation Quality Improvement (CDQI) Specialist performs daily evaluations of medical record documentation to include provider notes, lab results, diagnostic information and treatment plans, and communicates with providers face-to-face or via query forms to clarify or obtain the missing, unclear or conflicting documentation. The clarified physician documentation within the medical record results in the support of the overall quality and completeness of the medical record documentation for code assignment.

Responsibilities

Duties and responsibilities:

• Demonstrates an understanding of complications, co-morbidities, severity of illness, risk of mortality, case mix index, secondary diagnoses, and the impact of procedures on the final Diagnosis Related Group (DRG).
• Performs timely, accurate and complete documentation reviews of selected inpatient records to clarify conditions/diagnoses and procedures in which inadequate or conflicting documentation exists.
• Collaborates with physicians and other patient caregivers to support that appropriate reimbursement and clinical severity is captured for the level of service rendered to all patients with a DRG based payer.
• Improves coding specificity by educating physicians, clinicians, and other involved parties regarding the necessity of providing complete and clear documentation of the care provided throughout a patient’s stay.
• Follows AHA guidelines and coding clinics for coding and required documentation to ensure physician and hospital compliance. Remains current with coding information to ensure accuracy of codes assigned based on documentation.
• Queries physicians or physician extenders regarding missing, unclear, or conflicting health record documentation by requesting and obtaining additional documentation within the health record when needed.
• Keeps daily production logs containing number of cases reviewed, number of queries placed/responded, etc. for weekly evaluation of output.
• Conducts follow-up reviews of clinical documentation to ensure points of clarification have been recorded within the patient’s medical record.
• Maintains and keeps in total confidence, all files, documents and records.
• Meets or exceeds production and quality metrics.
• Performs all other job-related duties as it relates to job function as delegated by management

Qualifications

Requirements:

• Minimum Education: Registered Nurse and CCDS or CDIP certification
• Preferred Experience: Bachelors in Nursing
• Experience: 3 years CDI experience, 3 years of clinical experience in an academic medical center.
• Must pass a CDI skills competency assessment.

For remote work, this position requires that you provide a high-speed internet connection, subject to applicable expense reimbursement requirements (if any), and a work environment free from distractions.

Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. The estimated pay range for this role is $40 - $42 per hour.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

This job is not eligible for employment sponsorship.

Equal Pay Act Minimum Range