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CDI Specialist

Remote

Wilshire hires only the brightest and most experienced professionals in the healthcare revenue cycle management industry.  Wilshire will take the time to get know you and your employment history.  We will then place you in a role that will lead to a path of career success.  

About The Wilshire Group 

The Wilshire Group, a renowned boutique consulting firm in Los Angeles, specializes in revenue cycle optimization and fostering effective collaboration between operational and IT facets.  With a robust track record of aiding over 100 healthcare systems nationwide, our team thrives on professionalism, efficiency, and adaptability.

Our core values- professionalism, efficiency, and flexibility- underscore our commitment to creating an inclusive and dynamic workplace.  We embrace diverse narratives and believe in offering opportunities to exceptional individuals who bring their best to the table.

We are currently offering a contracted interim position at one of US News Best Hospitals 2022-23.  This position caters to top performers seeking a professional environment that acknowledges and values their dedication and proficiency.  While this role doesn’t offer benefits, it presents an opportunity to work within an organization that encourages talented individuals to surpass conventional boundaries.

Join us at The Wilshire Group, a place where talented professionals find a home to showcase their skills and contribute meaningfully to the healthcare landscape.

This is a contracted position for 3+ months.  Hourly Rate-$29.79 to $50.00 (based upon experience).  This position is 100%.

Job Description:

The Clinical Documentation Integrity Specialist II uses clinical and coding knowledge for conducting clinically based concurrent and retrospective reviews of inpatient and/or outpatient medical records to evaluate the clinical documentation of clinical services by identifying opportunities for improving the quality of medical record documentation. Facilitates and obtains appropriate physician documentation for any clinical conditions or procedures to support the appropriate communication, severity of illness, expected risk of mortality, and complexity of care of the patient.

A successful Clinical Documentation Integrity Specialist II will be adept in clinical experience and knowledge, understanding documentation and coding guidelines, recognizing gaps and issues, as well as the impact of documentation and coding on the patients, the providers, the hospital and related outcomes. 

Clinical Documentation Integrity Specialist II is the developing and intermediate working level. This professional applies acquired job skills, policies, and procedures to complete substantive assignments/ projects/ tasks of moderate scope and complexity; exercises judgment within defined guidelines and practices to determine appropriate action. Performs analytical work develop expertise needed to be fully functional CDI. Works closely with informal and formal leadership to assist in provider documentation initiatives and identification of barriers and potential solutions.

Performs moderately complex decision support work of limited scope and impact while developing in-depth knowledge of CDI and coding principles, techniques, and practices. May be responsible for providing support and management of work outside of assigned scope as business need or workload demands, in areas that are characterized by stability and/or under supervision/guidance. Responsibility will increase as experience grows. Clinical Documentation Integrity Specialist II continue training, receiving detailed instructions in new or specialty areas of CDI and concept expansion, and work under the general supervision of experienced Clinical Documentation Integrity Specialists, and other formal and informal leadership roles within the department.
Independently manages all work within the identified individual unit/service line.

Additional assignments outside of assigned scope as identified by leadership. Work is reviewed for accuracy and completeness per maintenance standard and as needed according to training and performance management needs.

Required Knowledge, Skills, and Abilities:

 Epic, Solventum, Excel. 

Knowledge of, but not limited to, current CMS coding guidelines and methodologies, MS-DRGs, APR-DRGs, HCCs; ICD-10-CM/PCS and AMA CPT coding guidelines and conventions. 

Demonstrates adaptability and self-motivation by staying abreast of CMS rules and regulations and incorporating those changes into daily practice 

 

Wilshire is honored that you have taken the time to review/apply to our open position.  We will now take the time to review your experience and be in touch with you soon.

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