Clinical Documentation Integrity Educator - Dept of Pediatrics

• Serving as the lead for internal staff education in this new role for the Department of Pediatrics, develop prescriber education as well as execute trend analysis to support department initiatives, and facilitating the improvement in the overall quality and completeness of provider-based clinical documentation to ensure that level of services and acuity is accurately reflected in the medical record.

• Supporting appropriate clinical documentation through extensive interaction with physicians, nursing staff, other patient caregivers, and external coding company to ensure that appropriate reimbursement is received for the level of services rendered to patients and the clinical information utilized in profiling and reporting is complete and accurate.
• Developing and delivering coding education programs for providers, staff, and new hires.
• Ensuring that all clinical treatment, decisions, and diagnoses documented, and coding accurately reflect the patient care.
• Providing orientation on coding, audit processes, and documentation standards.
• Answering coding and compliance questions from providers and staff.
• Serving as a resource for physicians to help link ICD10-CM coding guidelines and medical technology to improve accuracy of final code assignment.
• Querying physicians on a concurrent basis and utilizing software systems to collect, track, and report outcomes.
• Maintaining integrity of data collection.
• Collaborating with external coding staff to promote complete and accurate clinical documentation and correct negative trends. Leading advanced project-based work on topics to advance documentation initiatives in clinical practice.
• Participating in department and organizational projects related to clinical documentation
• Serving as the primary contact for staff workflows and education, including managing orientations, updating training materials, conducting audits, and monitoring industry practices and ICD code updates. Initiates and performs documentation review of selected records to clarify conditions/diagnoses and procedures where inadequate or conflicting documentation exists.
• Analyzing clinical information to identify areas within the chart for potential gaps in physician documentation.
• Collaborating with hospital compliance and Share Service Center - Coding and billing to manage clinical validation denials.
• Collaborating on appeal processes and assessing trends to support proactive improvements. Creating and implementing training and development programs for prescribers to address documentation.
• Helping to identify trends, variances, deficiencies, and problems utilizing data to support proposals to leadership and target education efforts.
• Working 40 hours, Monday-Friday. Hybrid/remote approximately 2-3 days per week on site, requiring flexibility depending on needs.

The Clinical Documentation Integrity Educator must have:

• Licensed Clinician including LPN, RN, PT, OT, Speech-Language, Pharmacist.
• Bachelor's degree or equivalent level or work experience.
• CPT coding certification required or willingness to become certified within 6 months of hire)
• Minimum of 3 years recent, broad-based clinical experience required, experience in both inpatient and outpatient settings preferred.
• 2 years of clinical chart review experience applying ICD coding knowledge to medical record review