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Type: Contract
Pay: Apply For Details
Location: Remote
General Information
- Specialty: IP CDI with Audit/Second Level Review Experience
- Engagement Type (FT/PT): Full Time
- Remote or Travel: Remote
- Length of Assignment: Indefinite, 6+ months
Credentials & Requirements
- Required Credentials: CCDS
- FMD / RN / Coder / Either: RN Preferred 5-10 yrs experience, 5 yrs clinical experience (preferrable complex specialties) with strong coding guideline background (no encoder in product)
Workflow & Systems
· Systems Used: Optum, 3M, Iodine; multiple tool experience
· Review identified CDI opportunities and validate model performance- summary of condition and clinical evidence to support.
· Perform real-time encounter reviews to ensure documentation meets defined criteria prior to customer delivery
· Conduct targeted review (not full-case review), prioritizing speed and accuracy
· Provide second-level CDI oversight, identifying issues that require deeper clarification
· Evaluate and support appropriate query opportunities and query compliance
· Collaborate closely with coding, CDI, and clinical stakeholders to ensure documentation aligns with coding guidelines and quality standards
· Deliver clear, factual, defensible findings and recommendations
· Support customer-facing discussions when needed (explaining rationale, standards, and recommendations)
· Maintain consistent turnaround times and quality under fast-moving workflows
· Communicate effectively on opportunities with UX, logic, and rules used to predict queries, identify additional opportunities not suggested, review for alternate pdx changes, and possibly missed codes/ coding errors.
Job Id: a1sVb000004Q9RxIAK