CDQI Audit Specialist

About the role

The CDQI Audit Specialist evaluates the quality, accuracy, and compliance of CDI reviews to identify opportunities for education and process improvement. This role provides feedback and performance monitoring to support the continuous improvement of the CDI program. The specialist plays a critical role in ensuring documentation integrity and supporting patient care outcomes.

Responsibilities

• Conduct retrospective and concurrent audits of CDIQ Specialists work to ensure accurate documentation review practices and compliant query generation.
• Review missed opportunities impacting reimbursement, quality reporting and patient outcomes.
• Collaborate with physicians and caregivers to ensure appropriate reimbursement and clinical severity for DRG-based payer patients.
• Evaluate CDQI staff adherence to organizational workflows, policies and industry standards.
• Maintain audit tools, scoring methodologies, and audit documentation.
• Provide individualized feedback to CDQI Specialists and develop education plans based on audit findings.
• Participate in onboarding and mentoring new CDQI staff.
• Deliver educational presentations on documentation, coding, regulatory updates and best practices.

Required skills

• CDI
• Auditing
• Clinical documentation
• EMR
• Epic
• Cerner
• 3M
• Iodine

Qualifications

• RN or BSN
• Must pass CDI skills competency assessment

Certifications

• CCDS
• CDIP

About the Company

Datavant is the data collaboration platform trusted for healthcare. The company provides critical data solutions for organizations across the healthcare ecosystem, including providers, health plans, researchers, and life sciences companies.