Clinical Documentation Integrity Specialist Job at CARLE, Maroa, IL

TVBzVXNNK3grMkY5YzlhWGIzbjdmL05pUXc9PQ==
  • CARLE
  • Maroa, IL

Job Description

Performs inpatient chart review to determine appropriate DRG assignment and assures appropriate documentation in the chart to support clinical care provided, including severity of illness and risk of mortality which impacts Case Mix Index and mortality ratings. Coordinates with physicians, nurses, ancillary staff, and the coders in Health Information Management to identify and record principal and secondary diagnoses, principal procedures, and assign the working DRG. Performs second level review of specific DRGs as assigned. Presents education related to CDI topics to peers and providers we needed or requested. Reviews DRG denials and provides information to the denials team related to appealing the encounter
  • Conducts the initial concurrent review process for all selected admissions.
  • Clarifies documentation in the medical record as appropriate through communication with the physicians, nurses, and ancillary staff. Assures documentation in chart represents a true clinical picture of the patient diagnoses and supports care that was given and DRG assigned.
  • Documents findings within Carle CDI software and updates software as required to reflect status of the encounter and any follow up.
  • Coordinates with the physicians, nurses, ancillary hospital staff, and Health Information Management Department's coding staff to identify and record principal and secondary diagnoses, principal procedures, and assign the working DRG.
  • Follows query process and escalates as necessary.
  • Conducts education related to CDI topics to peers and providers as needed or requested.
  • Performs second level review on selected inpatient encounters.
  • Reviews denials for accurate and complete documentation and develops appeal letter when needed.
    • Attends mandatory and regular education sessions as needed.
    • Follows appropriate workflow in EPIC and CDI software and notifies one up leader of any issues.
    • May serve as an "expert" and participate in testing for upgrades as needed.

Job Tags

Full time,

Similar Jobs

Walmart

(USA) Developmental Technician, Refrigeration/HVAC Maintenance Job at Walmart

 ...workforce across local retail stores and is actively recruiting Developmental Technicians specializing in** **Refrigeration and HVAC Maintenance** **. If you have experience in this field, we want you to bring your skills to our fast-paced and welcoming environment!****... 

Carney, Sandoe & Associates

Spanish Teacher Job at Carney, Sandoe & Associates

 ...Associates, an education recruitment firm, is currently seeking Spanish Teachers for the 2025-2026 academic year at private and...  ...and internationally. Spanish Teacher Responsibilities: Teach several Spanish courses across multiple proficiency levels, from... 

George Brazil

Residential Plumbing Field Supervisor Job at George Brazil

 ...Job Description Job Description Salary: DOE Looking for an Experienced Residential Service & Repair Plumbing Field Supervisor ARE YOU THE BEST AT WHAT YOU DO? Get rewarded!! Love the feeling of the mom-and-pop shop but miss all the benefits of working for... 

Summit Medical Staffing Nursing

Travel OR Tech - Surgical Services Job at Summit Medical Staffing Nursing

 ...Description Summit Medical Staffing Nursing is seeking a travel Surgical Technologist for a travel job in Springfield, Illinois. Job...  ...amount to be determined. Posted job title: Surgical Services - OR Tech / Surgical Tech @ Springfield Memorial Hospital About Summit... 

FORTÉ

Senior Audio-Visual Support Technician Job at FORTÉ

 ...and a bold new identity. The Senior Audiovisual Support Technician will be supporting a National Insurance Provider based in San...  ...events, meetings, and specialized projects, including high-end audio systems, multi-camera video conferencing setups, and integrated...