[Hiring] Clinical Documentation Integrity Specialist @Mosaic Life Care

Role Description

Works under the supervision of the Manager to complete basic to intermediate CDI reviews and re-reviews, submit queries to providers, complete first and second appeal levels. This position evaluates and partners with physician advisor on first and second level appeals, denial tracking. Rounding on patients, mortality reviews and second level reviews are also performed. Review and ICD-10-CM/PCS codes are assigned and appropriate DRG based on Official Coding Guidelines.

• Conducts basic to intermediate initial, concurrent and retrospective reviews of clinical documentation for all selected admissions to initiate the tracking process and document findings.
• Abstracts data from concurrent and retrospective charts, as well as computerized data systems using documentation, Official Coding Guidelines and Official Query Guidelines.
• Assigns and updates ICD-10-CM/PCS codes and baseline and working MS-DRG and APR-DRG DRG for accounts, reviewing in a timely manner and documenting thoroughly in clinical documentation integrity system.
• Identifies need to clarify documentation in records and initiates communication with provider utilizing the appropriate query tools.
• Reviews clinical validation denials and analyzes for appeal recommendation.
• Writes first and second level denial appeals in collaboration with physician advisor.
• Completes second level review including mortality reviews and quality reviews.
• Participates in staff training and departmental improvement activities.
• Communicates with coders to ensure that the correct DRG is assigned to each case.
• Collaborates with other members of the interdisciplinary team to achieve accurate documentation for coding.
• Assumes responsibility for professional development by participating in educational opportunities.
• Achieves CDI quality and productivity goals.
• Other duties as assigned.

Qualifications

• Associate's Degree - Nursing - Required
• Bachelor's Degree - Nursing - Preferred

Requirements

• 3 Years - Clinical experience in an ICU/Critical Care acute care setting - Required
• 1 Year - Experience in clinical documentation integrity functions - Preferred
• Registered Nurse (RN) - State Licensure/Or Compact State Licensure - Required Upon Hire
• Certified Clinical Documentation Specialist (CCDS) - Required within 2 Years
• Certified Documentation Improvement Practitioner (CDIP) - Required within 2 Years

Benefits

• Concierge services
• Employee lounge
• Wellness programs
• Free covered parking
• Free on-site and virtual health clinics
• Many more perks designed to ensure employees feel valued

Company Description

Mosaic Life Care is a health care system in northwest Missouri. With a vision of transforming community health by being a life-care innovator, Mosaic places the holistic needs of patients first by providing the right care at the right time and place, offering high value and quality health care.