RN Clinical Documentation Second Level Reviewer

UW Medical Center is an acute care academic medical center located in Seattle with two campuses: Montlake and Northwest. As the No. 1 hospital in Seattle and Washington State since 2012 (U.S. News & World Report) and nationally ranked in seven specialties, UW Medical Center prides itself on compassionate patient care as well as its pioneering medical advances. The UW Medical Center-Montlake campus is located on the edge of the beautiful UW campus which includes many amenities available to our staff as well as very convenient public transit options including the Sound Transit’s light rail station across the street. Excellence. Exploration. Education. Become part of our team. Join our mission to make life healthier for everyone in our community.

UW MEDICAL CENTER – MONTLAKE has an outstanding opportunity for a Second Level Review Clinical Documentation Integrity Specialist (RN). WORK SCHEDULE Full-time day shift. The work is fully remote. POSITION HIGHLIGHTS Following established policies, procedures, and professional guidelines, the Second Level Review Clinical Documentation Integrity Specialist (SLR CDIS) provides industry expertise on focused accounts that are set by the direction of CDP leadership to ensure high quality standards are met for risk adjustment, DRG accuracy, SOI and ROM. DEPARTMENT DESCRIPTION The Clinical Documentation Integrity Program (CDIP) performs concurrent review of inpatient medical records to ensure provider documentation accurately reflects patient severity of illness (SOI), acuity of care needs, risk of mortality (ROM) and the quality of treatment provided. Team members also serve on various multidisciplinary committees promoting quality improvement and patient safety initiatives.

Reviews target DRGs specified by CDP Manager, which is an evolving workflow. This review may focus various elements including, but not limited to, CC/MCC capture rate and/or risk adjustment review and will be clarified by DRG. Ensures that pertinent patient conditions and treatments are documented such that appropriate reimbursement is received for the level of acuity and service rendered to all patients using a DRG based payer (Medicare) methodology. Verifies the accuracy and completeness of clinical information used for measuring and reporting outcomes related to patient care, physician practice and the medical center performance. Participates in various projects and initiatives within the Clinical Documentation Program. Based on findings, department goals and initiatives and industry expectation, the SLR CDIS will participate in the education and evaluation of the CDI team. Collaborate with medical records coding staff, patient financial services (PFS) and compliance for Clinical Validation Denial appeals.