Clinical Documentation Improvement Specialist (CDI)

at  DaVita

REQUIREMENTS:

• Bachelor’s Degree with a current active clinical license (RN) (required)
• Master’s Degree with a current active clinical license (APRN) (preferred)
• Current Nurse Practitioner (NP) or Physician Assistant (PA) licensure without restriction in state of residence (preferred)
• CRC (required or must be obtained within six months of hire)
• CCDS-O or CDIP (required or must be obtained within one year of hire)
• 5+ years of clinical experience as a Nurse Practitioner (adult-geriatric or family) or Physician Assistance (preferred)
• 3+ years of clinical documentation improvement experience, coding experience, or equivalent (required)
• 1+ year of experience working with advanced practice providers as well as other clinical and non-clinical staff (required)
• Solid clinical background in evidence-based medicine, including chronic disease management and prevention.
• Experience in ICD-10 coding and documentation requirements and risk adjustment.
• Knowledge of compliant query writing/process
• Ability to perform a comprehensive chart review of 20-30 medical records daily, with workload variations based on daily tasks.
• Technical experience using EMR systems.
• Proficiency in MS applications (Excel, Outlook, Teams, PowerPoint, Word, Webex)
• Ability to travel for on-site meetings 2-4 times per year.
• Motivated self-starter and creative problem-solver who is comfortable working in a fast-paced, dynamic environment.

• Performs clinical chart reviews to ensure documentation accuracy by applying established clinical criteria for diagnosing medical conditions.
• Applies their clinical knowledge to evaluate how provider documentation, lab results, diagnostic information, and treatment plans translate into coded data.
• Analyzes and interprets clinical data to identify gaps, inconsistencies, and/or opportunities for improvement in the clinical documentation and queries the provider using a concurrent query process following ACDIS/AHIMA Guidelines for Compliant Query Writing.
• Communicate with providers and other healthcare team members to clarify information or provide additional documentation when needed.
• Work directly with clinicians to improve the overall quality and completeness of documentation through the query process and/or provider education (correct disease processes and disease severity, complexity, and acuity with an eye towards accurate medical coding).
• Collaborates with team members as part of the clinical review process to promote high accuracy and consistency of results.
• Meets accuracy and productivity metrics to ensure the team achieves established departmental goals.
• Communicates with DaVita leaders to address documentation issues and trends.
• Actively participates in all department meetings as scheduled.
• Conduct individual and large group educational sessions for clinicians and medical coders (or other staff as applicable).
• Partner with risk adjustment, coding, and education departments for onboarding, ongoing and targeted education for all NPs and IKC partner providers on documentation requirements for Medicare risk adjustment
• Partner with the education department on the ongoing chart review process to ensure continued high standards in documentation and coding, as well as aid in developing and monitoring inter-reviewer reliability testing.
• Flexible and able to adapt to change based on departmental needs.
• Excellent analytical and critical thinking skills.
• Excellent verbal/written communication and interpersonal skills.
• Ability to work independently and as part of a team in a fast-paced environment.
• Ability to work 2 days a week from the Denver office or fully remote with the ability to travel as needed to present in-person training (travel is 2-4 times per year).