CORP CDI AUDITOR-EDU

Covenant Health; Knoxville (TN); On-site; USD 70,000 - 90,000; Full time

Job summary

Covenant Health in Knoxville, TN is seeking a CDI Auditor & Educator to conduct audits and provide education related to coding, documentation, and compliance. This full-time position involves leading audit projects and supporting CDI staff through training and consultation.

Ideal candidates should have 3-5 years of CDI experience, extensive knowledge of healthcare billing processes, and relevant certifications. The role offers an opportunity to impact compliance and quality improvement in the organization.

Qualifications

• 3-5 years’ experience in CDI.
• Good knowledge of Medicare/Medicaid billing guidelines.
• Must have a certification relevant to the field.

Responsibilities

• Perform and review complex coding and clinical documentation audits.
• Educate and train CDI staff.
• Monitor compliance with coding and billing regulations.

Skills

Healthcare billing knowledge

Analytical reviews

Public relations skills

Educational skills

Education

Certification in field of study (RHIT/RHIA, CCS, CCDS, or CDIP)

Tools

Microsoft Excel

Windows OS

Job description

Overview

CDI Auditor & Educator

Full Time, 80 Hours Per Pay Period, Day Shift

Position Summary:

The CDI Auditor/Educator performs and reviews complex internal coding and clinical documentation audits for inpatient CDI accounts. This role leads or conducts audit projects across Covenant Health entities, focusing on coding, documentation, and billing compliance. The position also provides consulting services, coordinates coding investigations, and is responsible for education and training of CDI staff. The CDI Auditor/Educator serves as a resource to coders, CDI professionals, Quality and Case Managers, and Decision Support teams.

This role upholds all organizational and professional ethical standards and collaborates with Covenant leadership to coach, mentor, and train coding and CDI staff. The position operates independently with minimal supervision and significant latitude for initiative and independent judgment.

Responsibilities

• Identify and evaluate risk areas; develop and implement CDI auditing procedures related to documentation and reimbursement.
• Collaborate with coders and/CDI staff to provide education and feedback; proactively addresses issues with CDI management.
• Monitor CMS and OIG publications to ensure compliance with coding, billing, and reimbursement regulations.
• Reviews third- party payers guidelines to ensure accurate claims charging, coding, and billing.
• Communicate audit results through written reports and presentations to relevant stakeholders.
• Documents audit activities and report findings regularly.
• Serve as a resource for hospital departments regarding coding and documentation.
• Conduct CDI audits with regards to payor denials if/when necessary.
• Collaborate with health information management, Revenue Integrity, patient accounting, and other departments to implement compliance solutions.
• Support the Chief Compliance Officer on coding, billing and reimbursement compliance issues.
• Performs ongoing audits to identify process improvement education opportunities.
• Deliver detailed ICD-10 training to CDI staff.

General

• Maintains professional development through continuing education and industry engagement.
• Recognizes situations requiring supervision and seeking appropriate guidance.
• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.
• Performs other duties as assigned.

Qualifications

Minimum Education:

None specified; however, must be sufficient to meet the standards for achievement of the below indicated license and/or certification as required by the issuing authority.

Minimum Experience:

Three (3) to five (5) years’ experience in CDI. Good working knowledge of healthcare billing, Medicare/Medicaid billing guidelines, and other Third Party Payor rules and Regulations. Experience in problem solving, analytical reviews, Must be knowledgeable in use of PC's, Windows, Excel and Word Processing; Must have good public relations, educational skills.

Licensure Requirement:

Certification in field of study. The following certifications are acceptable RHIT/RHIA, CCS, CCDS, or CDIP.