CDI Quality Assurance Auditor - Part-Time

Datavant; Augusta (ME); On-site; USD 50,000 - 58,000; Part time

Job summary

Datavant, the data collaboration platform for healthcare, seeks a part-time CDQI Audit Specialist to evaluate CDI reviews for quality, accuracy, and compliance, and to identify opportunities for education and process improvement.

You will provide feedback, mentor staff, maintain audit tools, and collaborate with physicians to ensure appropriate reimbursement and DRG coding. This role emphasizes privacy, HIPAA, and high-quality patient care within a collaborative Datavanter team.

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 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 and regulatory requirements.

Skills

CDI experience

Auditing

Clinical collaboration

Education

RN or BSN with CCDS or CDIP

Tools

Epic

Cerner

3M

Iodine

Job description

Datavant, the data collaboration platform for healthcare, seeks a part-time CDQI Audit Specialist to evaluate CDI reviews for quality, accuracy, and compliance, and to identify opportunities for education and process improvement.

You will provide feedback, mentor staff, maintain audit tools, and collaborate with physicians to ensure appropriate reimbursement and DRG coding. This role emphasizes privacy, HIPAA, and high-quality patient care within a collaborative Datavanter team.