Lead Clinical Documentation Integrity Specialist
Catholic Health, Buffalo, New York, United States, 14266
Overview
Facility: Administrative Regional Training Cntr
Shift: Shift 1
Status: Full Time
FTE: 1.000000
Bargaining Unit: ACE Associates
Exempt from Overtime: Exempt: Yes
Work Schedule: Days
Hours: 8-4
Summary Under the direction of the Manager Clinical Documentation Integrity, the Lead Clinical Documentation Integrity Specialist is responsible for leading various training and operational matters including appropriate scheduling and coverage of cases, reconciling queries and DRG discrepancies, educating physicians, monitoring the program, and refining the process as needed, as well as training and mentoring new and current staff with regard to compliant documentation. The lead also serves as a secondary review/escalation point for potential or unanswered provider queries. The Lead Clinical Documentation Integrity Specialist is responsible for identifying areas of focus and necessary process refinements through report analysis. Leads CDI team in enacting process changes and measuring efficacy and impact of results. Serves as a resource to physicians and administration regarding issues related to the appropriateness of inpatient DRG assignment. Coordinates follow-up audits to ensure full compliance with regulatory requirements.
Responsibilities
EDUCATION
Bachelor of Science Nursing (BSN) degree
Registered Nurse with a current New York State license
CERTIFICATION
Certified Clinical Documentation Specialist (CCDS) is required within a year of hire
Must maintain New York State RN license
Experience
Minimum five (5) years of experience working within Clinical Documentation Integrity required
Five (5) years of clinical experience in an acute care setting as an Inpatient nurse or Case/Utilization Manager preferred
KNOWLEDGE, SKILL AND ABILITY
Demonstrated understanding of complications, co-morbidities, severity of illness, risk of mortality
Knowledge of ICD-10, current knowledge of coding clinics including recent changes/updates, and understanding of the various DRG methodologies (AP-DRG and MS-DRG)
Extensive clinical knowledge and understanding of pathology/physiology; best demonstrated by clinical experience in hospital setting
Self-Confident personality traits to facilitate ongoing physician communication
Excellent interpersonal communication (oral and in writing) and networking skills
Excellent critical thinking, discernment, and clinical assessment skills
Ability to relate well and establish partnerships with the providers to maximize the quality of documentation for Catholic Health patients
Ability to work independently in a time-oriented environment
Knowledge of Microsoft Office, Word, Excel and PowerPoint; Webex programs
WORKING CONDITIONS
Routine travel between acute care facilities and ambulatory offices
ENVIRONMENT
Normal heat, light space, and safe working environment; typical of most office jobs
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Summary Under the direction of the Manager Clinical Documentation Integrity, the Lead Clinical Documentation Integrity Specialist is responsible for leading various training and operational matters including appropriate scheduling and coverage of cases, reconciling queries and DRG discrepancies, educating physicians, monitoring the program, and refining the process as needed, as well as training and mentoring new and current staff with regard to compliant documentation. The lead also serves as a secondary review/escalation point for potential or unanswered provider queries. The Lead Clinical Documentation Integrity Specialist is responsible for identifying areas of focus and necessary process refinements through report analysis. Leads CDI team in enacting process changes and measuring efficacy and impact of results. Serves as a resource to physicians and administration regarding issues related to the appropriateness of inpatient DRG assignment. Coordinates follow-up audits to ensure full compliance with regulatory requirements.
Responsibilities
EDUCATION
Bachelor of Science Nursing (BSN) degree
Registered Nurse with a current New York State license
CERTIFICATION
Certified Clinical Documentation Specialist (CCDS) is required within a year of hire
Must maintain New York State RN license
Experience
Minimum five (5) years of experience working within Clinical Documentation Integrity required
Five (5) years of clinical experience in an acute care setting as an Inpatient nurse or Case/Utilization Manager preferred
KNOWLEDGE, SKILL AND ABILITY
Demonstrated understanding of complications, co-morbidities, severity of illness, risk of mortality
Knowledge of ICD-10, current knowledge of coding clinics including recent changes/updates, and understanding of the various DRG methodologies (AP-DRG and MS-DRG)
Extensive clinical knowledge and understanding of pathology/physiology; best demonstrated by clinical experience in hospital setting
Self-Confident personality traits to facilitate ongoing physician communication
Excellent interpersonal communication (oral and in writing) and networking skills
Excellent critical thinking, discernment, and clinical assessment skills
Ability to relate well and establish partnerships with the providers to maximize the quality of documentation for Catholic Health patients
Ability to work independently in a time-oriented environment
Knowledge of Microsoft Office, Word, Excel and PowerPoint; Webex programs
WORKING CONDITIONS
Routine travel between acute care facilities and ambulatory offices
ENVIRONMENT
Normal heat, light space, and safe working environment; typical of most office jobs
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