Candidates residing in the following states will be considered
for remote employment: Alabama, Colorado, Florida, Georgia, Idaho, Indiana,
Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North
Carolina, Oklahoma, Texas, Utah, and Virginia. Remote work will not be permitted
from any other state at this time
Works under the supervision of the Manager to complete basic to intermediate CDI
reviews and re-reviews, submit queries to providers, complete first and second
appeal levels. This position evaluates and partners with physician advisor on
first and second level appeals, denial tracking. Rounding on patients, mortality
reviews and second level reviews are also performed. Review and ICD-10-CM/PCS
codes are assigned and appropriate DRG based on Official Coding Guidelines.
RESPONSIBILITIES
Conducts basic to intermediate initial, concurrent and retrospective reviews
of clinical documentation for all selected admissions to initiate the
tracking process and document findings. Abstracts data from concurrent and
retrospective charts, as well as computerized data systems using
documentation, Official Coding Guidelines and Official Query Guidelines.
Assigns and updates ICD-10-CM/PCS codes and baseline and working MS-DRG and
APR-DRG DRG for accounts, reviewing in a timely manner and documenting
thoroughly in clinical documentation integrity system.
Identifies need to clarify documentation in records and initiates
communication with provider utilizing the appropriate query tools in order to
capture the documentation in the medical record that accurately supports the
patient’s severity of illness and risk of mortality.
Reviews clinical validation denials and analyzes for appeal recommendation.
Writes first and second level denial appeals in collaboration with physician
advisor. Completes second level review including mortality reviews and
quality reviews.
Participates in staff training and departmental improvement activities and
uses the results of the quality of quality audits to initiate change in
practice. Communicates with coders to ensure that the correct DRG is assigned
to each case; receives feedback as a means of continuous self-improvement
Collaborates with other members of the interdisciplinary team to achieve
accurate documentation for coding (example: rounds with physicians, attends
team conference).
Assumes responsibility for professional development by participating in
educational opportunities via webinars, online education and online meetings.
Achieves CDI quality and productivity goals.
Other duties as assigned
Education
Associate's Degree - Nursing - Required
Bachelor's Degree - Nursing - Preferred
Work Experience
3 Years - Clinical experience in an ICU/Critical Care acute care setting -
Required
1 Year - Experience in clinical documentation integrity functions - Preferred
Licenses and Certifications
Registered Nurse (RN) - State Licensure/Or Compact State Licensure - State
Licensure/Or Compact State Licensure in state, depending upon designated work
location - Required Upon Hire
Certified Clinical Documentation Specialist (CCDS) - Required within 2 Years
Or
Certified Documentation Improvement Practitioner (CDIP) - Required within 2
Years
QUALIFICATIONS
Skills and Abilities
Essential Technical/Motor Skills
Input and retrieve data, speaking clearly, answering phones, precise hand\eye
coordination, fine motor skills and good writing skills.
Clinical skills.
Interpersonal Skills
Ability to work with interruptions, and flexibility in hours and workflow,
foster teamwork and promote service and quality.
Excellent communication and critical thinking skills.
Essential Physical Requirements
Prolonged time spent looking at computer screen and keyboarding, sitting.
Essential Mental Abilities
Knowledge of care delivery documentation systems and related medical record
documents.
Knowledge of age-specific needs and the elements of disease processes and
related processes.
Read and interpret from the medical record, analyze encoder instructions,
understand documentation.
Function independently and have follow through skills, detail oriented.
Ability to prioritize work.
Essential Sensory Requirements
Visual, hearing.
Exposure to Hazards
Other Skills and Abilities
Mosaic Life Care is a health care system in northwest Missouri. With a vision of
transforming community health by being a life-care innovator, Mosaic places the
holistic needs of patients first by providing the right care at the right time
and place, offering high value and quality health care.
Mosaic has a wide array of benefits to meet each employee’s individual needs.
Our benefits were designed by listening to people just like you. Mosaic also
offers several perks with a focus on ensuring our employees feel valued,
including concierge services, employee lounge, wellness programs, free covered
parking, free on-site and virtual health clinics and many more. When paired with
compensation and recognition, it is what continues to make us the employer of
choice for employees at any stage of their journey.