*REMOTE work availability for the right candidate for this position*

Job Summary:

The CDI NICU Auditor/Educator supports the clinical staff in the NICU, Case Management and Revenue Cycle. The position will improve clinical documentation, accurate charge capture, and appropriate daily leveling of patients in the NICU at Women and Infants' Hospital. This role will function to educate physicians, non-physicians, clinicians, nurses, and other staff to facilitate documentation within the medical record to reflect the most accurate severity of illness, expected risk of mortality, hospital acquired conditions, patient safety indicators, and level of service rendered. The CDI NICU auditor will assist in putting together appeals/ rebuttals for external third party auditing sources.

Duties and Responsibilities:

Conduct individual and large group educational sessions for all clinical and non-clinical staff with NICU Leveling involvement - from documentation improvement to Interqual results.

Collaborate with DRG Validators for second level reviews for selected focus DRGs and other CNE facility review initiatives.

As needed, provides classroom and one-on-one training for NICU related cases to the CDI staff including initial CDI process and concept training and on-going education related to new topics in CDI, coding, and reimbursement in conjunction with CDI Manager.

Assist with NICU denials evaluation, trending and appeal submissions.

Collaborate with CDI Manager and other clinicians to facilitate the ongoing relevance of department specific orientation content, educational materials and documentation tip sheets and training programs/resources.

Collaborates with coding and quality team to communicate discrepancies in the capture of patient safety indicators, Hospital acquired infections, Hospital acquired conditions, and core measures.

Communicates with HIM staff and resolves discrepancies. Completes accurate input of documentation.

As needed, NICU provider (Physicians, Pas, NPs, Residents) education training on clinical documentation integrity concepts and best practices.

Attends educational programs to enhance knowledge of clinical area served. (i.e. Local RI ACDIS chapter, 3M’s CDI Network, 3Ms Quality Meetings, Pinson and Tang Webinars, etc.)

Assists in audits of CDI team as needed, makes appropriate recommendations for workflow improvement and accuracy as needed .

Assist CDI Manager with the preparation of data and reports to evaluate the effectiveness and overall impact of the clinical documentation improvement program for presentation to the Senior Leadership and other appropriate oversight committees.

Adhering to the Association of Clinical Documentation Improvement Code of Ethics and American Health Information Management Association’s code of ethics related to query process (Achieving A Complaint Query Process 2022 Update)

Requirements:

Bachelor's degree required.

Minimum of 5 years acute care experience and at least two years of recent inpatient experience.

Current Registered Nurse license required.

Certified Clinical Documentation Specialist (CCDS/CDIP) required; with additional Certified Coding Specialist (CCS) preferred.

The CDI NICU Auditor must be highly proficient in the proper assignment of facility NICU leveling and a basic understanding of ICD-10-CM/PCS and DRG codes.

Ability to demonstrate a broad and complex clinical knowledge base, and the ability to critically analyze the CDI process, clinical documentation, and opportunities for appropriate and complete documentation in the medical record.

Excellent oral and written skills and ability and knowledge to collaborate with clinical, operational and financial areas.

Highly proficient computer and technical skills, along with experience using MS Word, Excel, the EMR, 3M and CDI application.

Americans with Disability Act Statement: External and internal applicants, as well as position incumbents who become disabled must be able to perform the essential job-specific functions either unaided or with the assistance of a reasonable accommodation, to be determined by the organization on a case-by-case basis.

EEOC Statement: Care New England is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status

Ethics Statement: Employee conducts himself/herself consistent with the ethical standards of the organization including, but not limited to hospital policy, mission, vision, and values.