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CDI III Educator Auditor - Full Time - Days
Mohawk Valley Health System
Utica, NY, USA
USD 89k-115k / year
Posted on Apr 23, 2025
Job Summary
The CDI III Educator Auditor (Clinical Documentation Specialist) functions as a subject matter expert in denials management and education within the CDI department, providing comprehensive oversight of denial processes and educational initiatives. This position combines clinical expertise with advanced system knowledge to manage denials, drive educational improvements, and serve as the educational liaison between the CDI department and medical staff. The Specialist develops specialized educational initiatives while managing denial processes and responses, maintaining compliance with regulatory guidelines and coding conventions. This role emphasizes denial management, educational program development, and provider education.
Core Job Responsibilities
Provider Interaction and Clinical Documentation Review
- Creates and standardizes comprehensive denial response processes
- Manages denials workflow and response processes
- Coordinates with CDI staff on denial prevention strategies
- Ensures systematic documentation practices and develops, provides and presents education programs to staff, providers, residents and staff.
- Serves as a resource, coach and role model to other CDI Specialists.
Concurrent Chart Reviews and Documentation Validation
- Reviews denied cases for documentation improvement opportunities
- Validates clinical indicators in denied cases
- Analyzes denial patterns and trends
- Develops strategies to address documentation issues leading to denials
- Monitors documentation patterns for educational opportunities
- Reviews CDI work quality through denial analysis
- Creates educational content based on denial findings
Program Development and Education
- Acts as an educational liaison and subject matter expert. Develops training programs and activities for CDI Specialists, physicians and healthcare team members, including advanced denial prevention concepts.
- Creates and maintains educational resources for the department
- Collaborate with Coding leadership on coding education initiatives.
- Trains and precepts new CDI team members.
Quality Assurance and Compliance
- Ensures compliance with regulations, denial responses and denial response quality standards
- Performs related duties as required.
Education/Experience Requirements
REQUIRED:
- Associates degree in HIM, Nursing or related field or equivalent work experience.
- 4 years of Clinical Documentation experience including denial management and response.
- Expert understanding of medical terminology and clinical procedures
- Comprehensive knowledge of ICD-10 coding guidelines and documentation standards
- Advanced proficiency in CDI technology and healthcare information systems
- Strong presentation and teaching abilities
- Experience in developing educational programs
- Excellence in written and verbal communication
PREFERRED:
- Bachelor’s degree in a related field.
Licensure/Certification Requirements
REQUIRED:
- RHIA or RHIT certification or RN license
PREFERRED:
- CCDS/CDIP/CCS certification
Disclaimer
Qualified applicants will receive consideration for employment without regard to their age, race, religion, national origin, ethnicity, age, gender (including pregnancy, childbirth, et al), sexual orientation, gender identity or expression, protected veteran status, or disability.
Successful candidates might be required to undergo a background verification with an external vendor.
Job Details
Req Id 94354
Department CLINICAL DOCUMENTATION IMPROVE
Shift Days
Shift Hours Worked 8.00
FTE 1
Work Schedule SALARIED GENERAL
Employee Status A1 - Full-Time
Union Non-Union
Pay Range $89k - $115k/Annually