CDI Audit & Quality Improvement Specialist

Datavant; Montpelier (VT); On-site; USD 50,000 - 58,000; Full time

Benefits offered by this job

Health benefits

401k with match

PTO & holidays

Flexible schedule

Career growth

Job summary

Datavant seeks a Clinical Documentation Quality Improvement (CDQI) Audit Specialist to evaluate the quality and compliance of CDI reviews, provide feedback, and drive education and process improvements within the CDI program.

You will audit CDIQ Specialists, collaborate with physicians, and monitor program indicators while safeguarding PHI under HIPAA and company policies. The role is full-time and requires extensive CDI experience and certification.

Qualifications

• 5+ years of CDI experience and/or auditing.
• 3+ years of clinical experience in an academic medical center.
• RN or BSN with CCDS or CDIP certification.
• Must pass CDI skills competency assessment.
• Experience with various EMRs and CDI software including Epic, Cerner, 3M, Iodine, etc.
• Strong organizational, teamwork and communication skills.

Responsibilities

• Conduct retrospective and concurrent audits of CDIQ Specialists work to ensure accurate documentation review practices, compliant query generation, assess appropriate capture of: SOI, ROM, CC/MCC, HCC, and align with coding, quality and regulatory requirements.
• Review missed opportunities impacting reimbursement, quality reporting and patient outcomes. Collaborate with physicians and caregivers to ensure appropriate reimbursement and clinical severity for DRG-based payer patients.
• Evaluate CDQI staff adherence to organizational workflows, policies and industry standards.
• Maintain audit tools, scoring methodologies, and audit documentation
• Provide individualized feedback to CDQI Specialists and develop education plans based on audit findings.
• Participate in onboarding and mentoring new CDQI staff.
• Deliver educational presentations on documentation, coding, regulatory updates and best practices.
• Collaborate with Physician Advisor regarding documentation opportunities and trends.
• Monitor program performance indicators, including query rates, query response rates, agreement rates, accuracy scores, case mix index impact and CC/MCC capture rates.
• Maintain confidentiality and safeguard PHI, medical records, audit documentation, and company data in compliance with HIPAA, organizational policies, and regulatory requirements.
• Meet or exceed established production, quality, and performance metrics by completing assigned audits within designated timeframes and maintaining high standards of accuracy, consistency, and objectivity.

Skills

CDI Auditing

CDI Experience

RN/BSN

CCDS/CDIP

EMR Systems

Communication Skills

Education

RN or BSN with CCDS or CDIP

Job description

Datavant seeks a Clinical Documentation Quality Improvement (CDQI) Audit Specialist to evaluate the quality and compliance of CDI reviews, provide feedback, and drive education and process improvements within the CDI program.

You will audit CDIQ Specialists, collaborate with physicians, and monitor program indicators while safeguarding PHI under HIPAA and company policies. The role is full-time and requires extensive CDI experience and certification.