Role Description
The DRG Clinical Documentation Integrity (CDI) Educator acts as a subject matter expert to educate, train, and develop/revise processes in coordination with leadership to assist in achieving CDI’s goal of facilitating accurate and complete documentation for coding and the capture of severity, acuity, and risk of mortality and most accurate Diagnosis Related Group (DRG) assignments.
• Implements and continuously develops onboarding for all new Clinical Documentation Specialists (CDSs) for mentoring and education needs.
• Leads and coordinates training of new CDI staff.
• Collaborates with CDI leadership and other clinicians to facilitate the ongoing relevance of department-specific orientation content, educational materials, and training programs/resources.
• Formulates customized education to other healthcare professionals based on audience and areas of opportunity.
• Interacts with medical staff members, directors, and senior hospital leadership staff as needed.
• Makes recommendations for documentation improvement and queries to capture care and intensity of services as supported within the medical record documentation.
• Demonstrates understanding of complications, co-morbidities, severity of illness, risk of mortality, case mix index, secondary diagnoses, and the impact of procedures on the final Diagnosis Related Group (DRG).
• Educates members of the CDI team and providers on the review functions within the CDI program to meet and maintain enterprise goals and objectives, regulatory compliance, policies and procedures, and standard operating procedures.
• Assists with the development and maintenance of system CDI policies and procedures.
• Ensures program compliance by following coding guidelines and coding clinics.
• Serves as a key resource for accurate and ethical documentation standards and regulatory requirements.
• Demonstrates the ability to draft compliant queries as endorsed by AHIMA and ACDIS.
• Performs medical record reviews for completeness and accuracy in capturing severity of illness, risk of mortality, and clinical validation.
• Determines if professionally recognized standards of quality care are met.
• Audits CDSs as needed to ensure that system objectives are met.
• Develops educational plan for individual CDS based on Quality Audit (QA) outcomes.
• Provides 1:1 mentoring as needed.
• Oversees and coordinates SMART related education, meetings, and requirements for the department and as instructed by the SMART department.
Qualifications
• 3+ years related experience with clinical documentation and/or coding.
• Experience with multiple EMRs (Epic, Meditech, and Cerner).
• Detail oriented and self-motivated.
• Strong organizational skills.
• Excellent speaking and presentation skills.
• Working knowledge of Microsoft applications, including creation of PowerPoint presentations.
• Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.
Requirements
• Bachelor's Degree or Equivalent Experience.
• Licensure Required: MD (Doctor of Medicine) OR RN (Registered Nurse).
• Certification Required: Candidates must have and keep current at least one of the following professional certifications (CPC, CPMA or CCS Preferred):
• CCS (Certified Coding Specialist)
• CPC (Certified Professional Coder)
• CPMA (Certified Professional Medical Auditor)
• RHIA (Registered Health Information Administrator)
• RHIT (Registered Health Information Technician)
• Certified Revenue Cycle Representative (CRCR) completion within 9 months of hire.
Benefits
• Bonus Incentives.
• Paid Certifications.
• Tuition Reimbursement.
• Comprehensive Benefits.
• Career Advancement.
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