Clinical Documentation Integrity Specialist

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

 

About Duke Health's Patient Revenue Management Organization

 

Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.

Duke Nursing Highlights:

 

• Duke University Health System is designated as a Magnet organization
• Nurses from each hospital are consistently recognized each year as North Carolina's Great 100 Nurses.
• Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification.
• Duke University Health System has 6000 + registered nurses
• Quality of Life: Living in the Triangle!
• Relocation Assistance (based on eligibility)

 

This position will be responsible for utilizing their clinical/nursing knowledge and understanding of current CMS coding guidelines, conventions, and AHA coding clinics to improve the overall quality and completeness of the patient's medical record. Through a multidisciplinary team process, the ambulatory CDI specialist performs pre-visit and retrospective reviews of ambulatory clinical documentation to ensure an accurate depiction of the true complexity of the patient. This includes compliant documentation to support the capture of hierarchical condition categories (HCC), ICD-10-CM accuracy and specificity, and medical necessity. They work collaboratively with ambulatory physicians and advanced practice providers to communicate opportunities and educate members of the patient care team regarding documentation guidelines, coding requirements, and service-line-specific requirements. They also communicate with coders, compliance specialists, and/or clinical documentation analysts regarding documentation clarification and accurate coding, as needed. Participates in select committees and provides education programs as necessary.

 

Minimum Qualifications

 

 

Education

BSN or PA (Physician's Assistant) NP (Nurse Practitioner) or Doctorate in a medically related field is required.

 

Experience

 

Three years of progressive healthcare experience in an acute care setting. Previous chart review experience (case management utilization review) is preferred. Excellent written/verbal communication, critical thinking, creative problem-solving, and conflict management skills, in addition to proficient organization and planning skills, are required. Demonstrated knowledge of quality improvement theory and practice.

 

Degrees, Licenses, and Certifications

 

Currently licensed and/or registered as a Professional Nurse/Physician Assistant/MD in the state of North Carolina, preferred. CCDS, CCS, or CDIP preferred.

 

Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.

 

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

 

Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.