RN Educator, Clinical Documentation Integrity - Must Reside in Colorado

About this role

We are recruiting for a mission-driven RN Educator, Clinical Documentation Integrity - Must Reside in Colorado to join our team! We're with you for life’s journey. At Denver Health, purpose isn’t just something we believe in—it’s something we live every day, for life’s journey.

Our Values Respect | Belonging | Accountability | Transparency

Department REVENUE INTEGRITY

Job Summary

Under general supervision, the CDI Educator facilitates improvement in the overall quality, completeness, and accuracy of the medical record documentation through the education and training of the Clinical Documentation Integrity team and through extensive audit investigation, clinical criteria research, and data analysis. Develops, facilitates, and coordinates organizational CDI educational efforts including a formalized orientation curriculum and ongoing educational strategy to advance program outcomes. As requested by the CDI Manager, the educator performs concurrent and retrospective reviews, quality reviews, audits for internal compliance and performance, and supports clinical review for new technologies and projects. Responsible for educating providers regarding documentation specificity, accuracy, compliance and are permitted to query physicians as deemed necessary. Collaborates with Coding, Health Information Management (HIM), Patient Safety and Quality, Enterprise Compliance Services, Revenue Integrity, and other departments to promote the common goal of obtaining accurate documentation in the patient's record.

Essential Functions :

• Perform complex clinical documentation of designated inpatient, outpatient, and ambulatory patient records to assess for accuracy, specificity, and compliance of provider documentation. (15%)

• Draft and submit written queries to providers to achieve the necessary documentation clarification to achieve accuracy, specificity, and compliance of provider documentation. (10%)

• Develop and deliver a formalized CDI orientation process, leveraging industry-endorsed content, adult learning methodologies, and subject matter expertise to train new team members. (25%)

• Develop and perform an internal auditing process in partnership with the CDI Manager to validate query compliance and surface educational opportunities to inform the CDI continuing education plan. (15%)

• Educate providers, coder, and the CDI team regarding clinical documentation concepts, health data, quality outcomes, and compliance regulations. (15%)

• Partner with the Revenue Integrity and Compliance teams to support the appeal and education processes related to coding and documentation related denials. (10%)

• Inform new technology projects impacting CDI workflows, provider queries, and overall CDI program outcomes. (10%)

• (0%)

Education : • Bachelor's Degree Nursing or related field (or Associates Degree with equivalent level of additional experience) Required

Work Experience :

• 7-9 years of nursing experience with at least 2 years in an acute care setting Required and

• 1-3 years of CDI, clinical coding, DRG coordination, Medicare/Medicaid reimbursement experience. This experience can be included in the 7-9 years above. Required and

• 1-3 years of experience in education or supervisory experience preferred

Licenses : • RN-Registered Nurse - DORA - Department of Regulatory Agencies Required

Knowledge, Skills and Abilities :

• Knowledge of clinical criteria, pathophysiology, evidence-based practice and the ability to stay current on new trends in medical treatment. Ability to articulate concepts to physicians and other health care professionals in an effort to educate on clinical documentation requirements.

• Must be able to demonstrate clinical expertise in areas of urgent/emergent, medical/surgical, obstetrical, pediatric, and ambulatory care.

• Strong communication skills in order to successfully communicate complex ideas across different groups and educate on areas of needed improvement. Ability to act as a translator between clinical and non-clinical teams. Ability to work collaboratively with diverse groups and to effectively persuade and lead individuals/groups toward consensus.

• Ability to read and interpret professional journals, financial reports, and legal documents as necessary.

• Ability to define problems collects and summarizes data, establish facts and draw conclusions.

• Knowledge of CMS Medicare, Medicaid, Managed Care and Commercial health plan billing, reimbursement and regulations.

• Knowledge including but not limited to, value-based purchasing, bundled payments, accountable care organizations and readmission reduction program, and public reporting of quality outcomes.

• Possess strong critical thinking with the ability to autonomously prioritize work, manage time, and maintain organization to support efficiency and effectiveness.

• Knowledge of ICD-10-CM, ICD-10-PCS, Official Coding Guidelines, Coding Clinics, and other guiding references for coding accuracy and compliance.

• Knowledge of quality measures, patient safety indicators, value based purchasing, risk adjustments, mortality scoring, hospital acquired conditions, CMS 5 star, and external publicly reported quality metrics.

• Knowledge of compliance, practice briefs, white papers, and other publications guiding ethical and legal practices of CDI.

• Proficient with multi-platform computer software and applications in order to utilize tools appropriately to track, analyze, calculate, and summarize data and qualitative findings. Proficient with Microsoft suite.

• CDI or Coding certification preferred

Shift

Work Type Regular Salary $85,600.00 - $132,600.00 / yr

Benefits

At Denver Health, we take care of the people who take care of our community. Our benefits are built to support your life, your family, and your future — with generous paid time off, fully paid parental leave, exceptional retirement contributions, comprehensive health coverage, and nationally recognized well-being programs. We inves

Similar jobs

• Registered Nurse, Clinical Documentation Integrity Specialist — DaVita · Remote
• RN Care Coordinator - Denver Health Medical Plan (Must Live in Colorado. Weekly On Site Requirement.) — Denver Health · Denver Health Medical Plan - 601 Broadway, Denver, CO
• RN Nurse Clinical Documentation Improvement Specialist — R1 RCM · Remote
• RN Clinical Documentation Specialist Lead- Remote- Days — Ochsner Health · Remote
• RN, Clinical Documentation Integrity — Denver Health · Administrative Offices - 601 Broadway, Denver, CO
• RN Clinical Documentation Specialist - Referrals — Ensemble Health Partners · Putnam, CT
• RN Clinical Document Improvement Specialist — United Health Services · Binghamton, NY
• RN Registered Nurse, Denver CARES — Denver Health · Denver, CO