The Ambulatory Clinical Documentation Integrity Specialist (a CDI Specialist) is responsible for reviewing the overall quality and completeness of provider clinical documentation and risk adjustment code selection utilized to support reimbursement for both the professional and technical components. The aCDI Specialist
assists clinical practices and providers by providing education and support to better understand the relationship of documentation, code assignment, and risk adjustment of the patient population. The aCDI Specialist assists with analysis, trending, and identifying potential issues, root causes, and collaborative plans for improvement.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Provides education to providers on the appropriate code selection of ICD-10 diagnosis codes.
Performs retrospective reviews of patient accounts to identify potential diagnosis opportunities to support risk-adjustment, HCC coding, and educational opportunities.
Achieves and maintains current knowledge and understanding of ICD-10-CM and risk adjustment coding through participation in education and training including comprehension of ICD-10-CM Official Guidelines for Coding and Reporting, Coding Clinic, and other regulatory education programs and updates.
Demonstrates proficient knowledge of the Coding and Documentation Guidelines and standards of risk adjustment coding and applies this knowledge to the evaluation of medical record documentation.
Assists in the development of internal coding and documentation guidelines in accordance with risk adjustment and official coding guidelines.
Provides education to the providers regarding clinical documentation improvement and the need for accurate and complete documentation in the health record
Assists in development and training of ambulatory CDI principles.
Supports development of macros, templates, databases and other tools to support accurate documentation.
Identifies trends and/or opportunities to improve clinical documentation. Presents opportunities and potential solutions to the providers and ACO administration.
Demonstrates the highest level of confidentiality and conducts self according to AHIMA and AAPC Code of Ethics and ACDIS Code of Conduct.
Performs assigned work safely, adhering to established departmental safety rules and practices; reports to supervisor in a timely manner any unsafe activities, conditions, hazards, or safety violations that may cause injury to oneself, other employees, patients and visitors.
Performs other related duties as required.
Ambulatory Clinical Documentation Integrity Program Manager
EEO Statement: Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.
UPDATE: ChristianaCare is committed to prioritizing the health and safety of our patients and caregivers. As we continue to meet the needs of our caregivers and our community through the COVID-19 pandemic, our commitment to health and safety requires that we take new steps to ensure a safe environment for medical care for our patients and a workplace that avoids preventable harm for our caregivers. For this reason, vaccination for COVID-19 is required for all caregivers at ChristianaCare and is considered a safety standard that is job-related and consistent with business necessity for all caregivers.
ChristianaCare Health System is headquartered in Wilmington, Delaware and is one of the country's largest health care providers, ranking 21st in the nation for hospital admissions. Christiana Care is proudly a Nurse Magnet recognized institution. Christiana Care Health System is also one of the largest health care providers in the mid-Atlantic region, serving all of Delaware and portions of seven counties bordering the state in Pennsylvania, Maryland and New Jersey. A not-for-profit, non-sectarian health system, Christiana Care includes two hospitals with more than 1,100 patient beds, and is a major teaching hospital with two campuses. Christiana Care is continually recognized for excellence on a regional and national level. Our role in the community is expressed in the Christiana Care Way: "We serve our neighbors as respectful, expert, caring partners in their health. We do this by creating innovative, effective, affordable systems of care that our neighbors value."Christiana Care is a great place to work because we value diversity and recognize it to be a core part of our success. Because of the diversity of our employees, affiliated health professionals and volunteers, we are ...positioned to meet the unique needs of our patients and community. We acknowledge and celebrate the uniqueness and talent of each employee. Because of our talented workforce we are able to provide a quality healthcare experience to our patients and community. We strive to create an inclusive environment in which individual diversity can be leveraged and thrive. Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.