CDI Audit & Quality Improvement Specialist

Datavant; Salem (OR); On-site; USD 50,000 - 58,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

401k with match

PTO + holidays and floating holidays

Flexible work arrangements

Job summary

Datavant is seeking a CDQI Audit Specialist to evaluate the quality, accuracy, and compliance of CDI reviews, and to identify education and process improvement opportunities. The role focuses on ensuring proper documentation, coding alignment, and revenue integrity for DRG-based payers.

You will audit CDQI staff, provide feedback, participate in onboarding, and deliver educational sessions while safeguarding PHI and meeting production and quality targets.

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

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.

Skills

CDI auditing

Clinical experience

RN/BSN with CCDS/CDIP

CDQI competency assessment

EMR experience

Education

RN/BSN with CCDS/CDIP certification

Tools

Epic

Cerner

3M

Iodine

Job description

Datavant is seeking a CDQI Audit Specialist to evaluate the quality, accuracy, and compliance of CDI reviews, and to identify education and process improvement opportunities. The role focuses on ensuring proper documentation, coding alignment, and revenue integrity for DRG-based payers.

You will audit CDQI staff, provide feedback, participate in onboarding, and deliver educational sessions while safeguarding PHI and meeting production and quality targets.