Advanced CDI Quality Improvement Specialist II

Socket.dev; New York (NY); On-site; USD 80,000 - 109,000; Full time

Job summary

Mount Sinai Health System seeks a Clinical Documentation Quality Improvement Specialist II to enhance the accuracy, completeness, and quality of medical record documentation. The role requires auditing, physician interaction, and collaboration with HIM/coding teams to ensure correct DRG classification and appropriate level of service.

The ideal candidate has 2–4 years of CDI experience, strong knowledge of ICD-10-CM/PCS, DRG/CPT coding, and proven ability to write concise queries that elicit

Qualifications

• 2 years of CCS/CDIP/CCDS or equivalent.
• Good written, oral and interpersonal skills.
• Excellent problem solving and analytical skills.
• Strong organization skills.
• Attention to details.
• Demonstrated knowledge of ICD-10 CM/PCS codes, DRG and CPT coding.

Responsibilities

• Facilitates improvement in the overall quality, completeness and accuracy of medical record documentation through concurrent auditing and evaluation of the medical records.
• Facilitates accurate clinical documentation to ensure appropriate DRG classification is received for the level of service rendered to all patients with a Diagnosis-Related Group (DRG) payer
• Analyzes clinical status of patient, current treatment plan and past medical history to identify potential gaps in clinical documentation.
• Ability to write queries that are concise and easily understood by the queried provider, in order to garner additional necessary documentation in the inpatient medical record
• Timely reconciliation of all cases, to include accurate recording of DRG or SOI impact based on physician query, as well as physician response to all queries
• Identify query opportunities, diagnoses not supported by clinical indicators, and function on par with other CDI team members
• Demonstrate an understanding of complications, comorbidities, SOI, ROM, case mix, and the impact of procedures on the billed record, as well as the ability to impart this knowledge to providers and other members of the healthcare team
• Monitors activities to ensure that all clinical documentation is in compliance with State and Federal payer regulations
• Collaborate with HIM/coding professionals to review individual problematic cases and ensure accuracy of final coded data in conjunction with CDI managers, coding managers, and/or physician advisor
• Communicate with appropriate healthcare team members to promote accurate and complete documentation of diagnoses and/or procedures in the health record that have direct bearing on SOI.
• Act as a consultant to coding professionals when additional information or documentation is needed to assign coded data and clinical validation.
• Performs other related duties.

Skills

CDI experience

Communication

Problem solving

Attention to detail

ICD-10 coding knowledge

Education

CCS/CDIP/CCDS

Job description

Mount Sinai Health System seeks a Clinical Documentation Quality Improvement Specialist II to enhance the accuracy, completeness, and quality of medical record documentation. The role requires auditing, physician interaction, and collaboration with HIM/coding teams to ensure correct DRG classification and appropriate level of service.

The ideal candidate has 2–4 years of CDI experience, strong knowledge of ICD-10-CM/PCS, DRG/CPT coding, and proven ability to write concise queries that elicit