Coding Documentation Improvement (CDI) Manager/Educator:
Job Title: Clinical Documentation Improvement (CDI) Manager/Educator
Location: Remote
Department: Revenue Cycle Management
Reports To: VP Revenue Cycle Management
Job Summary:
The CDI Manager/Educator – Emergency Medicine plays a vital role in ensuring documentation integrity, compliance, and revenue optimization within emergency department (ED) billing. This position involves collaborating with external vendors, healthcare providers, and internal revenue cycle teams to enhance documentation accuracy, support proper coding and billing practices, and improve financial performance.
Key Responsibilities:
Clinical Documentation & Revenue Optimization:
- Develop and implement documentation improvement strategies that support accurate billing and reimbursement.
- Ensure proper E/M coding, critical care documentation, and severity of illness capture to minimize revenue loss.
- Work with external CDI vendors analyze trends, and implement best practices.
- Monitor and report on revenue impacts, denial rates, and CDI-driven financial improvements.
Provider Education & Engagement:
- Conduct targeted training sessions for emergency medicine physicians and APPs.
- Provide one-on-one feedback to ED providers on documentation requirements for procedures, diagnoses, medical necessity, and payer expectations.
- Develop educational materials, including guidelines for capturing accurate ED visit levels, observation admissions, and critical care time.
- Stay up to date with regulatory changes, payer policies, and industry best practices to refine training content.
Collaboration with External Vendors & Internal Teams:
- Partner with coding, revenue cycle, finance, and compliance teams to address documentation-related financial challenges.
- Participate in vendor-led audits and CDI improvement initiatives, using findings to drive corrective actions.
- Work with denial management teams to address documentation deficiencies that impact reimbursement.
Quality, Compliance & Regulatory Oversight:
- Ensure compliance with CMS, ICD-10, CPT coding, and payer-specific documentation guidelines.
- Conduct real-time audits to identify documentation gaps that could impact revenue and quality metrics.
Qualifications:
- CPC, RHIT, CDIP, CCDS, CCS, or similar CDI certification preferred.
- Minimum of 3-5 years’ experience in CDI, coding, or emergency medicine documentation.
- Experience working with external CDI/coding vendors and revenue cycle teams.
- Strong understanding of ED billing, CPT coding and payer requirements.
- Ability to communicate effectively with physicians, external vendors, and leadership teams.
Work Environment:
- Remote
- Frequent interaction with external vendors, revenue cycle teams, and coding professionals.