CDI Consultant - Second Level Review (SLR) - Part Time

At e4health, we Empower Better Health. The e4health Team is on a relentless mission to care for those teams who care for others. We bring our passion, ingenuity, and expertise to every engagement. In joining our Team, we want your help to provide our customers with powerful solutions in the pursuit of quality, integrity, clinical and financial value across healthcare.

Our People make the difference. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. e4health solutions streamline clinical, financial, and health information data and workflows, optimize coding, quality, and clinical documentation integrity processes, and address health IT operational challenges to deliver material results for healthcare organizations across the country. Learn more about us at www.e4.health.

The Clinical Documentation Integrity (CDI) Consultant will provide timely reviews of patient medical records to ensure accurate and complete documentation to reflect the patient’s severity and complexity of illness. The CDI Consultant is expected to work with providers and coders to ensure that documentation on the chart reflects the complexity of the patient. The ability to educate and interact with providers is essential.

• Ensures inpatient clinical documentation accurately reflects severity of illness (SOI) and Risk of Mortality (ROM) through concurrent and post discharge record reviews.
• Ensures Present on Admission (POA) clinical conditions are documented accurately and within defined regulatory timeframes.
• Ensures documentation reflects accurate safety rating scores and quality of care scores (PSIs)
• Under the direction of the HIM Documentation Education Manager, participates in education sessions and feedback to coders, CDI Reviewers, and Hospital Quality Departments.
• Conducts regular audits using standardized methodology to ensure compliance with POA, HACs and PSI documentation.
• Tracks and trends data for use by the HIM Documentation Quality and Education Manager in order to assist with CDI and Coding team quarterly data quality reviews. Escalates any observed issues which may impact the quality of documentation or coding.
• Ensures that coding and DRG assignment is in compliance with CMS rules and regulations as well as with current coding practices and conventions.
• Is familiar with OIG workplan to determine payor denial patterns in order to target education needs and additional focused audits.
• Applies information related to coding changes and DRG and quality score changes that could significantly impact data quality and/or revenue via Case Mix Index (CMI)

BENEFITS:

We offer an excellent salary, full benefits package including 401(k) with company match, medical, dental, vision, life, short/long term disability insurance, and PTO policy.

PHYSICAL DEMANDS OF THE ESSENTIAL FUNCTIONS:

Sitting, talking, hearing and near vision are required over 90% of the time. Feeling is required over 90% of the time and reaching is required about 50% of the time. The ability to travel to field sites may be required up to 15% of the time.

WORKING CONDITIONS WHILE PERFORMING ESSENTIAL FUNCTIONS:

Over 90% of the time is spent indoors, with protection from weather conditions. Exposure to noise levels that may be distracting or uncomfortable is present only in unusual situations.

e4health is an equal opportunity employer and will consider all applications without regard to race, color, religion, national origin, ancestry, marital status, veteran status, age, disability, pregnancy, genetic information, gender, sexual orientation, gender identity or any other legally protected category.

Applicants for U.S. based positions with e4health must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Visa sponsorship is not available for this position.

REQUIRED CLIENT QUALIFICATIONS:

• RN with BSN required
• 3+ years of clinical documentation experience
• Strong clinical training experience
• Second Level Review experience
• Epic and Solventum experience
• Strong analytical skills to clinically evaluate the medical record
• Ability to use a PC for medical record review along with proficiency utilizing Microsoft products (Excel, Word, Outlook)
• Ability to communicate effectively with e4health management and clients

PREFERRED QUALIFICATIONS:

• Smarter Dx experience
• Epic & 3M 360