CDI Concurrent Review and Query Specialist

HCA Healthcare (Corporate), based in Nashville, Tennessee, supports a variety of corporate roles from business operations to administrative positions. Like our colleagues in any HCA Healthcare hospital, our corporate campus employees enjoy unparalleledresources and opportunitiesto reach their potential as healthcare leaders and innovators. From market rate compensation to continuing education andcareer advancement opportunities, every person has a solid foundation for success. Nashville is also home to ourExecutive Development Program, where exceptional employees are groomed to take on CNO- and COO-level roles in our hospitals. This selective program focuses on ethics, leadership and the financial and clinical knowledge required of professionals at this level of the industry. HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

**This is a fully remote role but you must live within 60 miles of an HCA facility** Introduction Do you want to join an organization that invests in you as a CDI Concurrent Review and Query Specialist? At HCA Healthcare, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years. The Concurrent Review and Query Specialist interprets information within the company’s electronic health records to ensure complete and accurate provider documentation. As appropriate, generates and issues compliant queries to physicians for conflicting, imprecise, incomplete, illegible, or inconsistent clinical documentation. This individual need to function in a work from home environment.

Assessment of Documentation in Iodine: Perform high priority initial concurrent review and re-reviews of clinically indicated conditions or procedures supported by the appropriate assignment of severity of illness, expected risk of mortality and intensity of service. Analyze documented and clinically supported conditions in multiple electronic health record technologies to ensure complete documentation that can be coded to the highest level of specificity. Demonstrate knowledge of Official Coding Guidelines and the DRG Classification System to insure regulatory compliance related to the CDI and coding functions. As appropriate for DRG impact, assign Working and Target DRG if query response results in a primary diagnosis, procedure, and/or complication or comorbidity that changes the DRG due to more accurate documentation. Thoroughly document reviews, query follow up, and other pertinent information in designated systems by established deadlines. Achieve and maintain key operating metrics consistent with CDI program requirements. Physician Queries: Determine when and/or if a query to a physician is necessary through the use of critical thinking skills, independent discretion, and clinical judgement, Query physicians within established timelines via approved query forms for conflicting, imprecise, incomplete, illegible, or inconsistent documentation. Use clinical judgement to determine appropriate and relevant clinical indicators and/or reasonable diagnostic options when formulating patient-specific queries. Assess queries to determine if there is a thorough physician response, subsequent documentation exists and the query can be withdrawn, or if the query should be reassigned. Engage with physicians in query follow up in a clear and concise manner. Develop and maintain collaborative relationships with other CDI team members. Strategic Relationships: Develop and strengthen collaborative relationships with stakeholders to advance the care of our patients. Collaborate with others and possess excellent interpersonal skills. Deliver information in a clear, concise and compelling manner to effectively engage physicians. Deliver targeted and actionable communications that invites two-way professional communication. Adjust messages appropriately by audience. Demonstrate a willingness and ability to assist others. Self-Development: Demonstrate proficiency in current and emerging technologies. Simultaneously use multiple technologies to complete unique patient-level reviews. Independently take proactive steps toward problem resolution. Complete all mandatory and assigned education by established deadlines. Attend scheduled meetings and continuing education programs.