Consultant – Clinical Documentation Integrity, Healthcare

🌍 Remote, USA 🎯 Full-time 🕐 Posted Recently

Job Description

    Job Description:
  • Apply strong understanding of clinical documentation and care delivery workflows.
  • Conduct comprehensive inpatient medical record reviews for identified payer populations.
  • Serve as an educational resource to client CDI teams.
  • Develop and deliver training to physicians, nurses, coding professionals, and ancillary staff on documentation best practices.
  • Analyze clinical information to identify gaps in documentation related to SOI, POA, MS-DRG, APR-DRG, PSI, and quality measures.
  • Work collaboratively with coding teams to ensure accuracy and completeness of documentation and diagnoses.
    Requirements:
  • Bachelor’s degree in a related discipline preferred (RN, BSN, RHIA, RHIT, HIM, or similar).
  • 2-5 years of consulting experience with an RN or clinical background is required.
  • RNs without consulting experience will not be considered.
  • Experience working in an academic medical center preferred.
  • Current CCDS, CCS, or CDIP certification, or willingness and ability to obtain one, is required.
  • Strong understanding of DRG, MS‑DRG, APR‑DRG, and HCC methodologies.
  • Experience using EMRs such as Epic, Meditech, Cerner, 3M 360, etc.
  • Strong proficiency in MS Office (Word, PowerPoint, Excel, Outlook).
    Benefits:
  • Health insurance
  • 401(k) matching
  • Remote work options

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