CDQI Audit Specialist: Elevate CDI Quality & Compliance

Datavant; Pierre (SD); On-site; USD 50,000 - 58,000; Part time

Job summary

Datavant, a healthcare data collaboration platform, is seeking a part-time CDQI Audit Specialist to evaluate quality, accuracy and compliance of CDI reviews and to identify opportunities for education and process improvement. You will support continuous improvement of the CDI program and provide feedback to staff.

The role emphasizes auditing of CDI documentation, maintaining confidentiality and collaborating with physicians to ensure appropriate reimbursement and clinical severity for DRG-based

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 EMRs and CDI software including Epic, Cerner, 3M, Iodine.
• Strong organizational, teamwork and communication skills.
• Ability to maintain confidentiality and HIPAA compliance.

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, collaborating 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 and audit documentation in compliance with HIPAA.

Skills

CDI auditing

Clinical experience

EMR CDI software

Communication skills

Teamwork

Education

RN/BSN with CCDS/CDIP

Tools

Epic

Cerner

3M

Iodine

Job description

Datavant, a healthcare data collaboration platform, is seeking a part-time CDQI Audit Specialist to evaluate quality, accuracy and compliance of CDI reviews and to identify opportunities for education and process improvement. You will support continuous improvement of the CDI program and provide feedback to staff.

The role emphasizes auditing of CDI documentation, maintaining confidentiality and collaborating with physicians to ensure appropriate reimbursement and clinical severity for DRG-based