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Clinical Documentation Improvement Auditor, Registered Nurse
Riverside Health. Perform quality audits on CDI team members and provide education and feedback .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in clinical documentation improvement (CDI) and coding compliance, with a strong focus on education, auditing, and collaboration across healthcare teams. Proficient in developing training materials and maintaining knowledge of coding guidelines and regulations.
Highest-signal resume keywords
Clinical Documentation Improvement (CDI)Auditing ExperienceRegistered Nurse (RN) LicenseCertified Clinical Documentation Specialist (CD)Knowledge of Coding Practices
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Coding ComplianceQuality AuditsData AnalysisDocumentation StandardsClinical EducationQuery ProcessesMicrosoft OfficeEHREncoderAttention to Detail
Soft Skills
Strong Verbal CommunicationInterpersonal SkillsPresentation SkillsTime ManagementFollow-Through
Tools & Technologies
Microsoft ExcelMicrosoft PowerPointMicrosoft Word
Certifications & Qualifications
Certified Clinical Documentation Specialist (CD)Certified Documentation Integrity Practitioner (CDIP)Certified Coding Specialist (CCS)Registered Health Information Administrator (RHIA)Registered Health Information Technician (RHIT)
Industry Keywords
Coding StandardsReimbursement PoliciesClinical GuidelinesDRG GuidelinesHealthcare ComplianceMedical TerminologyHuman Disease ProcessAnatomy and Physiology
About the role
Key responsibilities & impact- Perform quality audits on CDI team members and provide education and feedback
- Ensure coding compliance using Coding Clinic, leading authorities, coding standards, regulations, corporate compliance standards, and reimbursement policies
- Identify training needs and ensure quality and productivity standards are met
- Provide education on compliant query processes and coordinate huddles as needed
- Maintain knowledge of new coding and DRG guidelines and regulations
- Implement policies and procedures related to coding and regulatory changes with the manager
- Prepare audit reports for CDI leadership
- Develop and maintain compliant physician query templates
- Serve as a clinical coding liaison and analyze documentation issues with relevant clinical, coding, medical, and departmental teams
- Develop and deliver CDI education for physicians, coders, and CDI team members
- Coach and develop team members to achieve team goals
- Assist patient financial services and coding team members with CDI, coding, and query questions
- Assist leadership with iCare initiatives related to hospital CDI
- Collaborate with Quality, CDI, Coding, leadership, and Physician Advisor teams as a CDI subject-matter expert/resource
- Prepare and present clinical documentation monitoring and trending reports
- Research and analyze data
- Document findings related to compliance reviews
- Adhere to established productivity standards
- Communicate case status and resolution with CDI and CDI Director
Requirements
What you’ll need- Associate degree in Nursing (Required)
- Bachelor's degree in Nursing or healthcare-related field (Preferred)
- 3-4 years nursing experience (Required)
- 3-4 years CDI experience (Required)
- 1 year auditing experience (Required)
- Knowledge of Microsoft Office, encoder, and EHR
- Ability to provide CDI and/or coding education to providers, CDI, and coders
- Strong verbal and written communication skills
- Excellent attention to detail
- Ability to apply audit standards
- Intermediate proficiency with Excel, PowerPoint, and Word
- Excellent interpersonal and presentation skills
- Strong time management and follow-through
- Knowledge of human disease process, anatomy and physiology, and medical terminology
- Understanding of coding practices, official coding guidelines, and federal regulations
- Ability to adapt to changes in the work environment
- Registered Nurse (RN) license required
- Certified Clinical Documentation Specialist (CD) or Certified Documentation Integrity Practitioner (CDIP) required
- Certified Coding Specialist (CCS), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT) preferred/optional
Benefits
Comp & perks- Remote work eligibility for candidates residing in specified states
- Full-time day shift