Clinical Documentation Integrity Auditor CDI

Apply for Job Job ID93747 LocationAurora, Colorado Full/Part TimeFull-Time Regular/TemporaryRegular Add to Favorite Jobs Why Work at Children's.... Here, it's different. Come join us. Children's Hospital Colorado has defined and delivered pediatric healthcare excellence for more than 100 years. Here, the nation's brightest nurses, physicians, scientists, researchers, therapists, and care providers are creating the future of child health. With an optimist's outlook, a trailblazing spirit, and a celebrated history, we're making new strides every day. We've been Magnet-designated four times by the American Nurses Credentialing Center and are consistently recognized among the best of the best pediatric hospitals with #1 rankings in Colorado and the region by U.S. News & World Report. As a national leader in pediatric care, we serve children and families from all over the nation. Our System of Care includes four pediatric hospitals, 11 specialty care centers, 1,300+ outreach clinics and more than 10,000 healthcare professionals representing the full spectrum of pediatric care specialties. Here, we know it takes all of us, every role, to deliver the best possible care to each child and family we treat. That's why we build our teams toward a foundation of equity in access, advancement, and opportunity. We know teams of individuals with different identities and backgrounds can nurture creativity and innovation. We know we can see, treat, and heal children better when our team reflects the diversity of our patient population. We strive to attract and retain diverse talent because we know a truly inclusive and equitable workforce will help us one day realize our most basic calling: to heal every child who comes through o A career at Children's Colorado will challenge you, inspire you, and motivate you to make a difference in the life of a child. Here, it's different. Job Overview The Clinical Documentation Integrity (CDI) Auditor is responsible for the overall quality, completeness, and accuracy of the medical record documentation through extensive audit review, clinical criteria research, drafting of appeals, and data trending. Internal auditing for the CDI program will ensure compliance, quality, denial trends, and educational opportunities are identified and solved in partnership with CDI leadership. Responsible for the review, appeal, and tracking of DRG denials received through government audits and/or commercial payers. Strong aptitude for quickly troubleshooting and identifying the cause of questionable results within abstracts and reports. Works in association with the CDI staff, clinicians, coders, and all members of the healthcare team to ensure accurate and timely clinical documentation in the medical record. Additional Information Department Name:Health Information Management Job Status: Full time, 40 hours per week Shift: Day Shift Fully Remote Qualifications EDUCATION - Associate Degree in Nursing. EXPERIENCE - Three (3) years of experience to include: one (1) year of experience within Clinical Documentation Integrity in the inpatient acute care setting and one (2) years of experience as a clinical nurse in an inpatient acute care setting. EQUIVALENCY - None. CERTIFICATION(S) - Certified Documentation Improvement Practitioner (CDIP) or Certified Clinical Documentation Specialist (CCDS) is required. LICENSURE - Active Registered Nurse licensure is required. Responsibilities POPULATION SPECIFIC CARE No direct patient care. ESSENTIAL FUNCTIONS An employee in this position may be called upon to do any or all of the following essential functions. These examples do not include all of the functions which the employee may be expected to perform. Manages the DRG denial and appeal process for CDI. Reviews DRG denial cases received from government audits and/or commercial payers.Research case content and denial rationale. Draft appeal letters with relevant citations from the clinical chart and appropriate clinical references to supp rt argument. Ensure timely submission of appeals through the appropriate workflows Track volumes, trends, outcomes, and other pertinent data elements needed to measure the success and/or identify continued risk to the organization for future denials and recoupment of funds. Collaborates with CDI Manager and CDI Educator to review trends related to denials, query activity, and revenue cycle opportunities to inform educational content and strategic planning for CDI, HIM Coding, or Provider audiences. Develops and delivers educational materials and presentations to individuals and/or group settings. Develops library of appeal templates... For full info follow application link. Equal Employment Opportunity It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. Be aware that none of the questions are intended to imply illegal preferences or discrimination based on non-job-related information. Remote About the Company: Children's Hospital Apply tot his job