CDI Concurrent Review and Query Specialist

Work from Home • Nashville-Davidson, TN, United States • $200k - $250k / year • 3d ago

This is a fully remote role, but you must live within 60 miles of an HCA facility

Introduction

Are you looking for a work environment where diversity and inclusion thrive? Submit your application for our CDI Concurrent Review and Query Specialist opening with us today and find out what it truly means to be a part of the HCA Healthcare team.

Job Summary and Qualifications

The Concurrent Review and Query Specialist interprets information within the company’s electronic health records to ensure complete and accurate provider documentation. As appropriate, generates and issues compliant queries to physicians for conflicting, imprecise, incomplete, illegible, or inconsistent clinical documentation. This individual needs to function in a work from home environment.

Major Responsibilities:

Assessment of Documentation in Iodine:

Perform high priority initial concurrent review and re-reviews of clinically indicated conditions or procedures supported by the appropriate assignment of severity of illness, expected risk of mortality and intensity of service.
Analyze documented and clinically supported conditions in multiple electronic health record technologies to ensure complete documentation that can be coded to the highest level of specificity.
Demonstrate knowledge of Official Coding Guidelines and the DRG Classification System to ensure regulatory compliance related to the CDI and coding functions.
As appropriate for DRG impact, assign Working and Target DRG if query response results in a primary diagnosis, procedure, and/or complication or comorbidity that changes the DRG due to more accurate documentation.
Thoroughly document reviews, query follow up, and other pertinent information in designated systems by established deadlines.
Achieve and maintain key operating metrics consistent with CDI program requirements.

Physician Queries:

Determine when and/or if a query to a physician is necessary through the use of critical thinking skills, independent discretion, and clinical judgment.
Query physicians within established timelines via approved query forms for conflicting, imprecise, incomplete, illegible, or inconsistent documentation.
Use clinical judgment to determine appropriate and relevant clinical indicators and/or reasonable diagnostic options when formulating patient-specific queries.
Assess queries to determine if there is a thorough physician response, subsequent documentation exists and the query can be withdrawn, or if the query should be reassigned.
Engage with physicians in query follow up in a clear and concise manner.
Develop and maintain collaborative relationships with other CDI team members.

Strategic Relationships:

Develop and strengthen collaborative relationships with stakeholders to advance the care of our patients.
Collaborate with others and possess excellent interpersonal skills.
Deliver information in a clear, concise and compelling manner to effectively engage physicians.
Deliver targeted and actionable communications that invite two-way professional communication. Adjust messages appropriately by audience.
Demonstrate a willingness and ability to assist others.

Self-Development:

Demonstrate proficiency in current and emerging technologies.
Simultaneously use multiple technologies to complete unique patient-level reviews.
Independently take proactive steps toward problem resolution.
Complete all mandatory and assigned education by established deadlines.
Attend scheduled meetings and continuing education programs.

Education & Experience:

Bachelor's degree or equivalent combination of education and/or experience required.
3+ years of experience in an acute care facility required.

Licenses, Certifications, & Training:

Registered Nurse - Currently licensed as a Registered Professional Nurse in the state of residence.
Or any coding credential nationally recognized as administered through AHIMA or ACDIS required.

If you find this opportunity compelling, we encourage you to apply for our CDI Concurrent Review and Query Specialist opening. We promptly review all applications. Highly qualified candidates will be directly contacted by a member of our team. We are interviewing apply today!

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

#J-18808-Ljbffr