[Hiring] Second Level Reviewer @Guidehouse

Role Description

The Clinical Documentation Integrity (CDI) Second Level Reviewer will perform the following responsibilities:

• Conduct comprehensive, clinical chart reviews to ensure accurate reflection of patient care and diagnosis.
• Collaborate closely with the CDI team, Physician Advisors, Providers, Clinicians, Coding Educators, Coding Quality Auditors, Case Managers, and Quality Department.
• Ensure documentation is clinically appropriate and reflects the severity of illness and risk of mortality.
• Apply ACDIS best practices for writing clinical documentation integrity clarifications.
• Identify opportunities for education with CDI team and other staff to improve documentation quality.
• Adapt to various clinical and administrative needs, participating in diverse projects and initiatives.
• Understand quality risk models and apply them during secondary reviews.
• Demonstrate excellent verbal and written communication skills.
• Act as a liaison between the Coding Department and Clinical Documentation Specialist.
• Exhibit adeptness in learning new technologies and utilizing EHR systems, CDI software, and encoders.
• Apply principles of clinical validation and ensure compliant queries.

Qualifications

• Graduation from accredited School of Nursing with BSN, ADN OR Graduation from accredited medical school with MD or equivalent OR bachelor’s or master’s degree in health-related field.
• Currently licensed as a Registered Nurse, MD or MD equivalent OR Credentialed Medical Coder through AHIMA with current CCS, RHIA or RHIT credential and CDIP or CCDS.
• 4-6 years previous relevant experience in clinical documentation, CDI second level review, or inpatient coding quality review.
• Strong understanding of disease processes, clinical indications, and treatments.
• Must maintain credentials while employed.

Requirements

• CCDS or CDIP certification (preferred).
• Strong clinical and critical thinking skillset.
• Experience with encoder and DRG assignments (MS and APR).
• Maintain working knowledge of Official Coding Guidelines, Coding Clinic, and federal updates to the DRG system.

Benefits

• 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.
• Tuition Reimbursement, Personal Development & Learning Opportunities.
• Skills Development & Certifications.
• Employee Referral Program.
• Corporate Sponsored Events & Community Outreach.
• Emergency Back-Up Childcare Program.