The RN - CDI Specialist position will function as a Second Level Reviewer. The main focus is post-coded and pe-billed with a focus on Medicare patients. The SLR performs post-discharge, final coded, pre-bill reviews of target case pupations (low acuity, long length of stay focus areas, sign & symptom principal diagnoses, compliance related clinical validation opportunities, HACs/PSIs, etc.) to verify that all conditions are accurately reported.

Our values of Excellence, Empathy, Integrity and Accountability are essential to exceed our customers’ expectations. At Reid, we look for individuals who believe in our core values and demonstrate a genuine desire to make a positive impact to those we serve.  We take pride in employing people who show up every day with a commitment to these values along with our mission and vision. We are one team working toward a common goal of providing outstanding customer care and service to our communities. If you have a calling to serve and are looking for meaningful and purposeful work, Reid Health is the place for you.

To lead our communities to well-being, one person at a time. It is not just what we do – it is who we are.

1. Performs post-discharge, final coded, pre-bill reviews of target case pupations (low acuity, long length of stay focus areas, sign & symptom principal diagnoses, compliance related clinical validation opportunities, HACs/PSIs, etc.) to verify that all conditions are accurately reported.
2. When appropriate, coordinate with front-line CDSs to query physicians for additional documentation or specificity to ensure completeness and accuracy of the medical record
3. As requested, monitors and educates CDI team to ensure clinically credible, effective, and compliant query practices
4. Responds to CDS requests for concurrent chart reviews
5. Analyzes reports and data to identify trends, ascertain areas of opportunity, and provide education to facility based CDSs and physicians based on this analysis
6. Responds to requests for clinical review and perspective on those cases when the CDS and Coder cannot reconcile the final DRG
7. Validate the appropriateness of Coder requests to withdraw an outstanding query
8. Responds to HIM coding requests for review from a clinical perspective
9. Assists with query escalation to the Physician Champions
10. Develops and promotes collaborative processes with CDS, Coding and Compliance, and strong working relationships with physicians and other health care professionals to accomplish program goals and ensure exceptional documentation

Education Required: ASN or Associate of Science in Helath Information Management

Education Preffered: Advanced degrees in Nursing or Health Information Management

Experience Required: 2 or more years working in an acute care setting or ambulatory office setting. Previous experience in CDI.

Licensure: Registered Nurse as applicable

Unexpected Perks - Daycare, Doordash, SmartDollar, Daily Pay, therapy dogs, massages, Forbes rated Best Places to Work 2022

Not quite what you are looking for? Submit your information here for general consideration. One of our employment specialists will be in touch with next steps.

EEO Statement: Reid Health is an Equal Opportunity Employer

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