CDI Audit Specialist — Part-Time Impact on Reimbursement

Datavant; Boise (ID); On-site; USD 50,000 - 58,000; Part time

Job summary

Datavant is seeking a part-time Clinical Documentation Quality Improvement (CDQI) Audit Specialist to evaluate CDI reviews’ quality, accuracy, and compliance while identifying education and process-improvement opportunities. You will provide feedback, training, and performance monitoring to support continuous CDI program improvement.

The role focuses on auditing CDIQ Specialists, collaboration with physicians, and ensuring proper DRG-based reimbursement.

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 experience

Auditing

Communication skills

Teamwork

Professional demeanor

Education

RN or BSN with CCDS or CDIP

Tools

Epic

Cerner

3M

Iodine

Job description

Datavant is seeking a part-time Clinical Documentation Quality Improvement (CDQI) Audit Specialist to evaluate CDI reviews’ quality, accuracy, and compliance while identifying education and process-improvement opportunities. You will provide feedback, training, and performance monitoring to support continuous CDI program improvement.

The role focuses on auditing CDIQ Specialists, collaboration with physicians, and ensuring proper DRG-based reimbursement.