Note: The job is a remote job and is open to candidates in USA. Solventum is a new healthcare company focused on improving lives through innovative solutions. The Clinical Documentation Specialist (CDI) will review inpatient medical records to ensure accurate and compliant clinical documentation, collaborating with healthcare professionals to enhance documentation quality and support proper coding.
Responsibilities
- Perform concurrent and/or retrospective reviews of inpatient medical records for documentation accuracy, completeness, and compliance
- Maintain an accuracy rate of 98%
- Identify opportunities for clarification of diagnoses, procedures, present on admission (POA) indicators, severity of illness, risk adjustment, and clinical validation
- Initiate compliant physician queries to clarify conflicting, incomplete, or nonspecific documentation
- Collaborate with coding staff to ensure accurate ICD-10-CM/PCS coding and MS-DRG/APR-DRG assignment
- Monitor documentation trends related to mortality, quality indicators, hospital-acquired conditions (HACs), patient safety indicators (PSIs)
- Conduct clinical validation reviews for diagnoses such as sepsis, respiratory failure, encephalopathy, malnutrition, acute kidney injury, and other high-risk conditions
- Maintain productivity and quality standards established by Solventum/facility Query rate of 35-40%, review rate of 20-25 cases per day and an accuracy rate of 98%
- Participate in multidisciplinary rounds, provider education, and documentation improvement initiatives
- Assist with denial prevention by supporting documentation integrity initiatives
- Stay current with CMS, ICD-10, AHA Coding Clinic, and organizational compliance standards
Skills
- Valid Registered Nurse license with a bachelor's degree or higher (completed and verified prior to start)
- Seven (7) years of Nursing experience
- Five (5) years of experience in the inpatient acute care setting
- Experience auditing practices, ICD 10, PCS guidelines, quality initiatives, and MS-DRG and APR DRG methodologies
- Clinical knowledge and application to coding
- Experience in CCDS, CCS, or CDIP with (7) seven years of clinical documentation/DRG validator
- Knowledge of the Solventum HIS software portfolio (e.g., 360 Encompass)
- Experience with telecommuting, working with EMRs and other electronic tools with current chart auditing skills
- Knowledgeable in Solventum HIS software portfolio (360 Encompass)
- Proficient Microsoft Word, Excel and PowerPoint and other Microsoft Office programs and excellent verbal, written, presentation, analytical and organizational skills
Benefits
- Medical
- Dental & Vision
- Health Savings Accounts
- Health Care & Dependent Care Flexible Spending Accounts
- Disability Benefits
- Life Insurance
- Voluntary Benefits
- Paid Absences
- Retirement Benefits
Company Overview