Responsibilities
POSITION SUMMARY: The Compliance Auditor - Clinical Documentation Integrity (CDI) is responsible for improving the overall quality, completeness and appropriate utilization of systems used to perform clinical documentation review and query functions for the South Texas Region. Compliance Auditor focuses on CDI compliance with the rules and regulations of regulatory agencies, compliance with South Texas Region/UHS policies and procedures through process of internal audits and denial reviews/audits. Promotes a partnership between the concurrent clinical reviewers, medical record coders, denials team and physicians to improve the accuracy of documentation and reimbursement for each facility. Supports and promotes the accuracy and completeness of the clinical information used for measuring and reporting physician and hospital outcomes to reflect the patient's true severity of illness, intensity of care, and risk of mortality. Responsible for internal audits, appeals, research on coding guidelines and/or regulations. Communicates with Regional CDI Manager, Regional Coding Manager, Supervisors and HIM management to accomplish hospital's objectives. Educates members of the health care team on an ongoing basis regarding CDI compliance and new or updated coding clinics and assists with CDI concurrent review needs when needed. Position is a remote position with occasional need to work from the facility and/or attend meetings.
Qualifications
QUALIFICATIONS: 1. 3 to 5 years acute care inpatient CDI experience required 2. Excellent written and verbal communication skills required. 3. One to two years experience in leadership role, preferred. 4. Auditing experience of acute care IP CDI required. 5. Demonstrates ability to review all coding skills related to assignment of diagnosis, procedures and DRG's 6. Ability to read medical reports, interpret lab values pertinent to coding diagnoses, abstract pertinent information from records and to provide meaningful information by telephone or letter in replying to inquiries. 7. Medical terminology, anatomy and physiology required. 8. Computer skills and excellent customer service skills are required. 9. Ability to recognize, analyze and resolve process problems. 10. Flexibility of schedule and ability to work remotely. Must be able to provide high speed internet at place of residence at the expense of the employee, with a work area that is in adherence to privacy and security policies and procedures. 11. Must demonstrate commitment and adherence to STHS's Compliance Program and Code of Conduct through compliance with all policies and procedures, the Code of Conduct, attendance at required training and immediately reporting suspected compliance issue(s) to the Compliance Officer. EDUCATION / LICENSURE: 1. Associate or Bachelor's Degree in Nursing or Health Information Management; Advanced degree such as medical doctor or nurse practitioner acceptable/preferred. International MD degree acceptable. 2. CCDS or CDIP Certification preferred. EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. Notice At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.
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