The Clinical Documentation Improvement Program (CDI) is designed to improve the physician's documentation in the patient's medical record supporting the appropriate severity of illness, expected risk of mortality and complexity of care of the patient. The role of the Clinical Documentation Improvement Educator is to provide one-on-one and classroom clinical documentation and coding education to Clinical Documentation Improvement Specialists, medical staff, mid-level providers, and other healthcare staff members. Remains accessible as a subject matter expert for CCHS regarding documentation, reimbursement, and data interpretation as it relates to inpatient records. Conducts the quality review of inpatient CDI cases, queries, assigned codes, and working DRGs.
Educates and mentors new CDI and Coding employees through the onboarding process.
Educates groups and individuals within and external to CDI regarding documentation, coding, DRG, ICD-0 code assignment, and the reimbursement process.
Interacts with and educates physicians and mid-level providers individually and in groups.
Trains CDI staff on initial CDI process, concept training, and ongoing education related to new topics in CDI, coding, and reimbursement.
Supports CDI staff with new technology and technology updates.
Assists with and provides suggestions for continuing education topics and issues for CDI staff.
Monitors CDI compliance through quality audits and data analysis.
Provides feedback to the CDI management team and staff regarding ICD-0 CM and PCS coding, DRG assignment, and related clinical documentation issues or concerns.
Analyzes and evaluates clinical and operational systems and processes relative to inpatient reimbursement and quality statistics through chart review and other special study methods.
Recommends data quality improvements and revenue enhancements.
Develops and maintains CCHS facilities CDI policies and guidelines in accordance with AHIMA Practice Beliefs, Official Coding Guidelines, ACDIS Standards, and Coding Clinic.
Assists with the analysis of CDI reports and other statistical reports.
Supports CDI program initiatives.
Anticipates and responds to changing skills requirements.
Seeks opportunities to learn new skills and actively coaches and encourages team members to do the same.
Complies with CCHS and departmental policies and procedures consistently.
Work is typically performed in a clinical environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position.
Bachelor's Degree-Nursing (Required)
Minimum of 6 years-Clinical (Required)
Certification(s) and License(s)
Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania
We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh Food
Farmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencing
programs, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.
Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers.
What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.