CDI Specialist: Elevate Clinical Documentation & Quality

ScionHealth; Columbus (GA); On-site; USD 65,000 - 85,000; Full time

Job summary

ScionHealth’s St. Francis–Emory Healthcare in Columbus, GA seeks a Clinical Documentation Integrity (CDI) Specialist to enhance medical record accuracy, severity of illness, and reimbursement through physician collaboration and audits.

You will work with physicians, nurses, coders, and HIM colleagues to ensure compliant, high-quality documentation. Qualifications include a nursing or health information management background, CDI/ ICD-10 expertise, and 3+ years of relevant experience.

Qualifications

• 3+ years clinical experience in inpatient care or documentation review.
• Experience with CDI, ICD-10-CM/PCS, MS-DRGs and coding guidelines.
• Knowledge of CMS regulations and IPPS guidance.
• Strong attention to detail and documentation accuracy.

Responsibilities

• Perform concurrent reviews of inpatient records for clarification and completeness.
• Initiate and follow up on provider queries per coding standards.
• Abstract clinical data to support DRG accuracy.
• Educate physicians and staff on documentation best practices.
• Review POA, HACs, and other quality indicators.
• Collaborate with case management, quality, compliance, and HIM teams.
• Analyze trends in documentation improvement and query response rates.
• Maintain knowledge of CMS regulations and coding guidelines.
• Assist with documentation audits and performance improvement.
• Present educational sessions to providers and staff.
• Uphold patient privacy and coding regulatory standards.

Skills

CDI knowledge

ICD-10-CM/PCS

Communication skills

EMR systems

Analytical thinking

Education

Associate’s Degree in nursing, health information management or related healthcare field

Bachelor’s Degree in nursing, health information management or related healthcare field (Preferred)

Master’s Degree in nursing, health information management or related healthcare field (Preferred)

Tools

EMR systems

Data analytics tools

Job description

ScionHealth’s St. Francis–Emory Healthcare in Columbus, GA seeks a Clinical Documentation Integrity (CDI) Specialist to enhance medical record accuracy, severity of illness, and reimbursement through physician collaboration and audits.

You will work with physicians, nurses, coders, and HIM colleagues to ensure compliant, high-quality documentation. Qualifications include a nursing or health information management background, CDI/ ICD-10 expertise, and 3+ years of relevant experience.