CDI III Educator Auditor

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