CDI Lead Specialist at Conifer Health Solutions — USA | Base Career

Educates members of the patient care team regarding documentation guidelines, including attending physicians, allied health practitioners, nursing, and case management.

Assists with overseeing department workflow and metrics.

Educates and trains department staff.

Responsible for reviewing medical records to facilitate and obtain appropriate physician documentation for any clinical conditions or procedures to support the appropriate severity of illness, expected risk of mortality, and complexity of care of the patient.

Educates members of the patient care team regarding documentation guidelines, including attending physicians, allied health practitioners, nursing, and case management.

Assists with overseeing department workflow and metrics.

Educates and trains department staff.

Include the following.

Others may be assigned.

Completes initial medical records reviews of patient records within 24-48 hours of admission for a specified patient population to: (a) evaluate documentation to assign the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate MS-DRG assignment, risk of mortality and severity of illness; and (b) initiate a review in host system.
Conducts follow-up reviews of patients every 1-3 days to support and update the working MS-DRG, as necessary.
Formulates physician queries due to missing, unclear or conflicting documentation as necessary.

Provides daily support/mentoring/training to new CDI hires as well as existing CDI staff.
Provides assistance in managing escalated issues and special projects as needed to supervisors and managers. CDI staff coverage as necessary
Performs concurrent and/or retrospective CDI reviews as necessary
Provides CDI support/mentoring/training to Physicians and hospital leadership as necessary.
Enters facility specific data to dashboards as necessary

Resolves problems, concerns and reports issues with Operations to Supervisor, Manager or Director.

Assists with orientation of new CDI Staff

Completes yearly required learnshares
Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD coding.
Attends mandatory coding sessions on annual basis (IPPS and ICD updates) for inpatient coding.
Quarterly review of AHA Coding Clinic.
Attends Quarterly Coding Updates and all coding conference calls as well as any required CDI education.

Provider Engagement: Conducts provider rounding, provides education, and communicates with providers on documentation and physician query opportunities as appropriate for follow up and resolution.

Other duties as assigned

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.

The requirements listed below are representative of the knowledge, skill and/or ability required.

Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Must display teamwork and commitment while performing daily duties
Must demonstrate initiative and discipline in time management and medical record review
CDI Subject Matter Expert with Advanced knowledge of Medicare Part A and familiar with Medicare Part B
Intermediate knowledge of disease pathophysiology and drug utilization
Intermediate knowledge of MS-DRG classification and reimbursement structures
Critical thinking, problem solving and deductive reasoning skills
Effective written and verbal communication skills
Knowledge of coding compliance and regulatory standards
Excellent organizational skills for initiation and maintenance of efficient workflow
Capacity to work independently in a virtual office setting or at facility setting if required to travel for assignment.
Understand and communicate documentation strategies
Recognize opportunities for documentation improvement
Formulate clinically, compliant credible queries
Ability to comply with an auditing and monitoring program as a means to measure query process
Ability to apply coding conventions, official guidelines, and Coding Clinic advice to health record documentation
Must be able to resolve issues effectively and provide recommendations and solutions
Effectively explain processes and educate others
CDS SME with ongoing education with physicians and facility leaders
CDI facility representation for hospital and physician meetings
Local facility mentorship for CDI team support and effectiveness
CDI staff coverage as necessary
Gathering additional data as needed for supervisor, manager and director

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment.

This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

Include minimum education, technical training, and/or experience required to perform the job.

Preferred: Two (2) or more years’ experience in CDI
Graduate from a Nursing program, RN, BSN, Medical Doctor, Foreign Medical Doctor, and/or graduate of Health Information Management RHIT, RHIA preferred
Preferred: Two (2) years’ experience with either HIM/Coding or Case Management experience.

Required: RN, Medical Doctor, Foreign Medical Doctor, or RHIT, RHIA, and/or CCS
Preferred: CDIP or CCDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Ability to sit for extended periods of time
Must be able to efficiently use computer keyboard and mouse
Good visual acuity

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Must be able to travel as needed, not to exceed 10%

As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide.

We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare.

Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost, and access to healthcare.

Are you ready to be part of our solutions?

Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!

Pay: $81,952 - $122,907 annually.

depends on location, qualifications, and experience.

Management level positions may be eligible for sign-on and relocation bonuses.

Conifer offers the following benefits, subject to employment status:

Medical, dental, vision, disability, life, and business travel insurance
Paid time off (vacation & sick leave) – min of 12 days per year, accrued accrue at a rate of approximately 1.84 hours per 40 hours worked.
401k with up to 6% employer match
10 paid holidays per year
Health savings accounts, healthcare & dependent flexible spending accounts
Employee Assistance program, Employee discount program
Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
For Colorado employees, Conifer offers paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.

CDI Lead Specialist

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