Clinical Documentation Integrity Specialist (CDI Expert)

Nwregionalheart; Roseville (CA); Hybride; USD 90 000 - 115 000; Plein temps

Résumé du poste

Adventist Health Roseville is seeking a Clinical Documentation Integrity Specialist (onsite) to ensure accurate medical records and coding for quality measures. You will review records, draft provider queries, and collaborate with CDI, coding and quality teams to close documentation gaps.

You will support education on best practices, participate in audits, and stay current on CDI trends. Must have CDI experience, clinical background, and relevant certifications.

Qualifications

• Associate's/Technical Degree in Nursing, Health Information Management, or related clinical field or equivalent.
• Bachelor's Degree preferred.
• Three years' CDI/clinical documentation or coding experience required.
• Two years' clinical experience required.
• Familiarity with PSI/HAC validation, mortality reviews and external quality reporting. Exposure to risk adjustment concepts (HCC, SOI/ROM).

Responsabilités

• Performs chart reviews of inpatient medical records using criteria and checklists.
• Drafts provider queries using approved templates when clarification is needed.
• Supports coding accuracy for quality measures through case reviews.
• Communicates with physicians and clinical staff regarding documentation clarification.
• Provides education on documentation best practices to clinicians.
• Participates in audits and metrics tracking within the quality program.

Connaissances

CDI experience

Clinical documentation

Provider communication

Formation

Associate's/Technical Degree in Nursing or HIM

Bachelor's Degree preferred

Three years' CDI/clinical documentation or coding experience

Two years' clinical experience

Description du poste

Adventist Health Roseville is seeking a Clinical Documentation Integrity Specialist (onsite) to ensure accurate medical records and coding for quality measures. You will review records, draft provider queries, and collaborate with CDI, coding and quality teams to close documentation gaps.

You will support education on best practices, participate in audits, and stay current on CDI trends. Must have CDI experience, clinical background, and relevant certifications.