CDI Audit & Quality Improvement Specialist

Datavant; Saint Paul (MN); On-site; USD 50,000 - 58,000; Full time

Benefits offered by this job

Health insurance

401k with match

Paid time off

Job summary

Datavant is seeking a Clinical Documentation Quality Improvement Audit Specialist to lead retrospective and concurrent CDI audits, improve documentation accuracy, and drive revenue integrity in a healthcare data platform environment.

You will mentor staff, develop education plans, review CDQI workflows, monitor performance metrics, and collaborate with physicians to optimize DRG capture while maintaining HIPAA compliance.

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.

Responsibilities

• Conduct retrospective and concurrent audits of CDI 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 audits

EMR systems

Regulatory knowledge

Education & feedback

Communication

Education

RN/BSN

CCDS/CDIP

Tools

Epic

Cerner

3M

Iodine

Job description

Datavant is seeking a Clinical Documentation Quality Improvement Audit Specialist to lead retrospective and concurrent CDI audits, improve documentation accuracy, and drive revenue integrity in a healthcare data platform environment.

You will mentor staff, develop education plans, review CDQI workflows, monitor performance metrics, and collaborate with physicians to optimize DRG capture while maintaining HIPAA compliance.