Clinical Documentation Integrity Nurse

Job Description: The Clinical Documentation Integrity Nurse (CDI RN) utilizes clinical expertise, expert coding knowledge, and critical thinking skills to work collaboratively with Medical Directors. This position provides high-level expertise in the areas of coding and contracting, insurance regulations, and risk adjustment capitated revenue. Nurses review complex clinical provider notes and communicate with providers to meticulously identify ambiguous documentation or discrepancies between documentation and the patient's clinical presentation. This position also provides education and training to customers (physicians, mid-level providers, office staff) on clinical indicators and risk adjustment capitated revenue. Essential Functions Ensure clinical documentation is accurate, specific, complete, and compliant to reflect the severity of illness and risk of mortality of the patient. Work collaboratively with providers to identify opportunities for the accuracy and quality of chart documentation. Identify complications and co-morbid conditions, specify co-existing and causal conditions, and follow up with providers responsible for the care of the patient for appropriate documentation. Identify the need to clarify documentation in the medical record by communicating with providers face-to-face or in written communication. Stay abreast of coding guidelines, risk adjustment payment methodologies, regulatory compliance, and quality-based programs. Maintain thorough and current knowledge of clinical care and treatment options to critically assess the accuracy and appropriateness of documentation. Maintain thorough clinical knowledge of disease processes, pathophysiology, and pharmacology. Demonstrate excellent communication and interaction skills to diplomatically handle difficult, complex, and/or potentially political situations with physicians, office staff during clinic in-person on-site work, and other external and internal customers and departments. Serve as a resource for providers to educate on linking coding guidelines and medical terminology to capture opportunities. Perform other duties as assigned, including but not limited to the orientation of caregivers. Skills Clinical Knowledge Chart Review Accuracy Critical Thinking Educational Leadership Data Analysis ICD -10 Coding Clinical Communication & Coordination Clinical Documentation Integrity Health Care Compliance Schedule/Additional Details: Monday - Friday No weekends No holidays Must live in the greater Las Vegas Area for on site clinic days Minimum Qualifications Bachelor’s degree in nursing (BSN) from an accredited institution (degree will be verified). Current RN License in state of practice. Demonstrated clinical nursing experience in a diverse setting. Demonstrated experience in clinical documentation integrity and/or outpatient coding. Demonstrated experience in chart reviews and/or auditing. Strong communication skills to effectively convey complex ideas. Ability to thrive in a fast-paced environment and manage multiple tasks simultaneously. Ability to work independently with minimal supervision. Proficient in using Electronic Medical Record (EMR) tools Preferred Qualifications Five (5) years of clinical nursing experience in a diverse setting. Demonstrated clinical experience in ICU, primary care, admissions, and discharges. Proficient in Microsoft Office Suite. Physical Requirements Interact with others; verbally communicate as well as hear and understand spoken information. Operate computers, telephones, office equipment, including manipulating paper requiring the ability to move fingers and hands. See and read computer monitors and documents. Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment. Location: Nevada Central Office Work City: Las Vegas Work State: Nevada Scheduled Weekly Hours: 40 The hourly range for this position is listed below. Act ... (truncated, view full listing at source)