CDQI Audit Specialist — Flexible, Quality & Compliance

Datavant; Sacramento (CA); On-site; USD 50,000 - 58,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

401k with match

Paid time off

Job summary

Datavant is seeking a Clinical Documentation Quality Improvement (CDQI) Audit Specialist to evaluate CDI reviews, improve education, and enhance revenue integrity. You will provide feedback, monitor performance, and contribute to continuous CDI program improvements.

The role is full-time and involves auditing, education, and collaboration with physicians to ensure accurate documentation and appropriate reimbursement, while safeguarding PHI and complying with HIPAA.

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, teamwork and communication skills.

Responsibilities

• Conduct retrospective and concurrent audits of CDI Specialists' work to ensure accurate documentation review practices, compliant query generation, and appropriate capture of SOI, ROM, CC/MCC, and HCC.
• Review missed opportunities impacting reimbursement, quality reporting and patient outcomes; collaborate with physicians and caregivers for appropriate reimbursement and clinical severity for DRG-based payer patients.
• Evaluate CDQI staff adherence to 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 such as query rates, accuracy scores, and CC/MCC capture rates.

Skills

CDI auditing

Healthcare quality

Regulatory compliance

Education & training

Strong communication

Education

RN or BSN

CCDS or CDIP certification

Tools

Epic

Cerner

3M CDI

Iodine CDI

Job description

Datavant is seeking a Clinical Documentation Quality Improvement (CDQI) Audit Specialist to evaluate CDI reviews, improve education, and enhance revenue integrity. You will provide feedback, monitor performance, and contribute to continuous CDI program improvements.

The role is full-time and involves auditing, education, and collaboration with physicians to ensure accurate documentation and appropriate reimbursement, while safeguarding PHI and complying with HIPAA.