2000 16th Street,Denver,Colorado,80202,United States of America

Job Description

Clinical Documentation Integrity Specialist

We are looking for teammates who reside in Mountain Standard Time (MST) or Pacific Standard Time (PST)

This person is required to have experience in:

Experience in ICD-10 coding and documentation requirements and risk adjustment.

Knowledge of compliant query writing/process

Our team is looking for a detail-oriented, clinically trained RN or PA who can provide expertise, education, coaching, and guidance on clinical practice and documentation to improve our clinical outcomes and increase the capture of pertinent diagnosis codes and quality measures. This individual will serve as a role model and facilitator within the clinical documentation integrity team and support the leadership team with the execution of the department's vision. They are self-directed and possess advanced analytical skills, critical thinking, creativity, and the ability to anticipate and identify opportunities and potential problems.

Essential Duties and Responsibilities:

Performs clinical chart reviews to ensure documentation accuracy by applying established clinical criteria for diagnosing medical conditions.

Applies their clinical knowledge to evaluate how provider documentation, lab results, diagnostic information, and treatment plans translate into coded data.

Analyzes and interprets clinical data to identify gaps, inconsistencies, and/or opportunities for improvement in the clinical documentation and queries the provider using a concurrent query process following ACDIS/AHIMA Guidelines for Compliant Query Writing.

Communicate with providers and other healthcare team members to clarify information or provide additional documentation when needed.

Work directly with clinicians to improve the overall quality and completeness of documentation through the query process and/or provider education (correct disease processes and disease severity, complexity, and acuity with an eye towards accurate medical coding).

Collaborates with team members as part of the clinical review process to promote high accuracy and consistency of results.

Meets accuracy and productivity metrics to ensure the team achieves established departmental goals.

Communicates with DaVita leaders to address documentation issues and trends.

Actively participates in all department meetings as scheduled.

Conduct individual and large group educational sessions for clinicians and medical coders (or other staff as applicable).

Partner with risk adjustment, coding, and education departments for onboarding, ongoing and targeted education for all NPs and IKC partner providers on documentation requirements for Medicare risk adjustment

Partner with the education department on the ongoing chart review process to ensure continued high standards in documentation and coding, as well as aid in developing and monitoring inter-reviewer reliability testing.

Flexible and able to adapt to change based on departmental needs.

Excellent analytical and critical thinking skills.

Excellent verbal/written communication and interpersonal skills.

Ability to work independently and as part of a team in a fast-paced environment.

Ability to work 2 days a week from the Denver office or fully remote with the ability to travel as needed to present in-person training (travel is 2-4 times per year).

Requirements:

Bachelor's Degree with a current active clinical license (RN) (required)

Master's Degree with a current active clinical license (APRN) (preferred)

Current Nurse Practitioner (NP) or Physician Assistant (PA) licensure without restriction in state of residence (preferred)

CRC (required or must be obtained within six months of hire)

CCDS-O or CDIP (required or must be obtained within one year of hire)

5+ years of clinical experience as a Nurse Practitioner (adult-geriatric or amily) or Physician Assistance (preferred)

3+ years of clinical documentation improvement experience, coding experience, or equivalent (required)