Lead Clinical Documentation & CDI Expert

Driscoll Health Plan; Austin (TX); On-site; USD 110,000 - 140,000; Full time

Job summary

Driscoll Health Plan seeks a Lead Clinical Documentation Department Improvement Specialist to oversee the CDI team, including licensed nurses and coders, ensuring accurate inpatient documentation and coding for APR-DRG reimbursement.

The role emphasizes leading reviews of complex pediatric cases, educating physicians and staff on MS-DRG/APR-DRG methodologies and collaborating with CDI Physician Champion and care teams to improve documentation quality and reporting.

Qualifications

• RHIA/RHIT/CCS/CDIP/CCDS preferred with 2+ years ICD hospital-based coding experience, or RN/LVN/BSN with 3+ years pediatrics/Med-Surg/ICU/Surgery.
• Strong communication skills; proficiency with Microsoft Outlook, Word, and Excel.

Responsibilities

• Acts as subject matter expert for CDI, inpatient coding, and reimbursement methodologies.
• Educates medical staff on MS-DRG and APR-DRG reimbursement processes.
• Oversees CDI reviews and coordinates with HIM management.
• Queries physicians to clarify documentation for accuracy and completeness.
• Monitors case mix patterns and trends to identify improvement opportunities.
• Maintains knowledge of payer regulations and reporting guidelines.
• Collaborates with CDI Physician Champion and care teams to optimize documentation.
• Prepares and presents monitoring/trending reports for review.

Skills

Leadership

Clinical Documentation

Query Management

Education & Training

Education

RHIA

RHIT

CCS

CDIP

CCDS

Tools

Epic

3M CRS

3M CDI 360 Encompass

Outlook

Word

Excel

Job description

Driscoll Health Plan seeks a Lead Clinical Documentation Department Improvement Specialist to oversee the CDI team, including licensed nurses and coders, ensuring accurate inpatient documentation and coding for APR-DRG reimbursement.

The role emphasizes leading reviews of complex pediatric cases, educating physicians and staff on MS-DRG/APR-DRG methodologies and collaborating with CDI Physician Champion and care teams to improve documentation quality and reporting.