Tenet Healthcare CDI RN Specialist in Houston, Texas
As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!
Responsible for reviewing medical records to facilitate and obtain appropriate physician documentation for any clinical conditions or procedures to support the appropriate severity of illness, expected risk of mortality, and complexity of care of the patient, by improving the quality of the physicians’ clinical documentation. Exhibits a sufficient knowledge of clinical documentation requirements, MS-DRG Assignment, and clinical conditions or procedures, Educates members of the patient care team regarding documentation guidelines, including attending physicians, allied health practitioners, nursing, and case management.
ESSENTIAL DUTIES ANDRESPONSIBILITIES
Include thefollowing. Others may be assigned.
Record Review: Completes initial medical records reviews ofpatient records within 24-48 hours of admission for a specified patientpopulation to: (a) evaluate documentation to assign the principal diagnosis,pertinent secondary diagnoses, and procedures for accurate MS-DRG assignment,risk of mortality and severity of illness; and (b) initiate a reviewworksheet. Conducts follow-up reviewsof patients every 2-3 days to support and assign a working or final MS-DRGassignment upon patient discharge, as necessary. Formulate physician queriesregarding missing, unclear or conflicting health record documentation byrequesting and obtaining additional documentation within the health record, asnecessary. Collaborates with case managers, nursing staff and other ancillarystaff regarding interaction with physicians regarding documentation and toresolve physician queries prior to discharge.
Assist in training department staff newto CDI
Professional Development: Stays current with AHA Official Coding andReporting Guidelines, CMS and other agency directives for ICD-9-CM and CPTcoding. Attends mandatory codingseminars on annual basis (IPPS and OPPS, ICD-9-CM and CPT updates) forinpatient and outpatient coding. Quarterlyreview of AHA Coding Clinic. AttendsQuarterly Coding Updates and all coding conference calls as well as anyrequired CDI education.
CDI:Communicates/Completes Clinical Documentation Improvement (CDI)activities and coding issues (lacking documentation, physician queries, etc.)for appropriate follow-up and resolution
Other duties as assigned
To perform this jobsuccessfully, an individual must be able to perform each essential dutysatisfactorily. The requirements listed below are representative of theknowledge, skill and/or ability required. Reasonable accommodations may be madeto enable individuals with disabilities to perform the essential functions.
CDI Specialist must display teamwork andcommitment while performing daily duties
Must demonstrate initiative anddiscipline in time management and medical record review
Travel may be required to meet the needsof the facilities
Advanced knowledge of Medicare Part Aand familiar with Medicare Part B
Intermediate knowledge of diseasepathophysiology and drug utilization
Intermediate knowledge of MS-DRGclassification and reimbursement structures
Critical thinking, problem solving anddeductive reasoning skills
Effective written and verbalcommunication skills
Knowledge of coding compliance andregulatory standards
Excellent organizational skills forinitiation and maintenance of efficient work flow
Regular and reliable attendance and timereporting per Conifer Telecommuting program requirements
Capacity to work independently in avirtual office setting or at facility setting if required to travel forassignment
Understand and communicate documentationstrategies
Recognize opportunities fordocumentation improvement
Formulate clinically, compliant crediblequeries
Ability to maintain an auditing andmonitoring program as a means to measure query process
Ability to apply coding conventions,official guidelines, and Coding Clinic advice to health record documentation
Include minimumeducation, technical training, and/or experience required to perform the job.
Preferred: Acute Care nursing relevant experience
Zero (0) to two (2) years of experience
Graduate from a Nursing program, BSN, orgraduate
Active state Registered Nurse license
Preferred: CDIP or CCDS
The physical demandsdescribed here are representative of those that must be met by an employee tosuccessfully perform the essential functions of this job. Reasonableaccommodations may be made to enable individuals with disabilities to performthe essential functions.
Ability to sit for extended periods oftime
Must be able to efficiently use computerkeyboard and mouse
Good visual acuity
- Must be able to travel nationally asneeded, not to exceed 10%
Job: Conifer Health Solutions
Title: CDI RN Specialist
Requisition ID: 1905037046