CDI Specialist

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems, and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. 

As our CDI Specialist, you will be responsible for supporting and facilitating the overall quality of medical record documentation by improving the completeness, accuracy, and reliability of clinical documentation. Every day, you will obtain appropriate clinical documentation through an extensive review of provider, nursing, ancillary, and other patient caregivers' documentation, to ensure that appropriate documentation and reimbursement is received for the level of services rendered to patients. On an ongoing basis, the CDI Specialist is responsible for supporting the direction and focus of education for providers and the coding staff within their assigned scope of work. The CDI Specialist must exercise independent judgment, critical thinking, and ability to work independently while interpreting and following CMS guidelines, organizational policies, and procedures. To thrive in this role, you must have a minimum of 3 years of recent clinical bedside experience in the ICU, Tele, Med/Surg, or ED setting.

Here’s what you will experience working as a CDI Specialist:

• Review patient records for the assigned patient population to evaluate documentation to assign the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate MS-DRG or APR-DRG assignment in compliance with coding guidelines and regulatory requirements.
• Conduct focused reviews in areas identified by CDI leadership: mortality reviews, PSI reviews, as well as other identified projects.
• Serve as a subject matter expert and authoritative resource on interpretation and application of CDI practices, coding rules, and regulations and conduct risk assessments of potential and detected compliance deficiencies, as well as documentation improvement opportunities.
• Draft and submit compliant queries to providers in compliance with industry compliance standards; conduct follow-up reviews of clinical documentation to ensure points of clarification with providers have been accurately recorded in the patient's medical record.
• Reconcile reviewed cases with final coding and communicate with coders to identify the root cause of CDI-Coder final DRG mismatch and resolution of incongruence as part of ongoing quality control efforts. 

Required Skills:

• An active RN license

The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.

Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a competitive benefits package.

R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.

If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.

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To learn more, visit: R1RCM.com

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