Senior Clinical Documentation Specialist Auditor - Clinical Doc Integrity - Full Time 8 Hour Days (Non-Exempt) (Non-Union)
Core
Reviews inpatient medical records to identify documentation opportunities for accurate severity of illness, risk of mortality, and hospital quality metrics.
Role type
Senior Clinical Documentation Specialist Auditor (IC)
Builds
Accurate APR & MS DRG assignments, compliant documentation, and quality outcome metrics.
Domain
Healthcare / Clinical Documentation Improvement (CDI)
Required skills
ICD10-CM & PCS coding, CDI hospital quality metrics (PSI, HACs, Elixhauser), Inpatient Prospective Payment System (IPPS), physician query generation, clinical validation, denial management, root cause analysis
Preferred skills
Certified Coding Specialist (CCS), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP)
Technologies
CDI software
Responsibilities
Directs and educates physicians and clinical staff on CDI processes; performs audits for denial prevention, quality comorbidities, and risk adjustment; conducts retrospective reviews for mortality and quality metrics; authorizes clinical validation appeals; supports team operations and training; acts as subject matter expert for CDS and coders.
Seniority
Senior, hands-on IC with mentorship duties
