CDI Auditor & Educator

Position Summary

The CDI Auditor/Educator performs and reviews complex internal coding and clinical documentation audits for inpatient CDI accounts. This role leads or conducts audit projects across Covenant Health entities, focusing on coding, documentation, and billing compliance. The position also provides consulting services, coordinates coding investigations, and is responsible for education and training of CDI staff. The CDI Auditor/Educator serves as a resource to coders, CDI professionals, Quality and Case Managers, and Decision Support teams.

This role upholds all organizational and professional ethical standards and collaborates with Covenant leadership to coach, mentor, and train coding and CDI staff. The position operates independently with minimal supervision and significant latitude for initiative and independent judgment.

Responsibilities

• Identify and evaluate risk areas; develop and implement CDI auditing procedures related to documentation and reimbursement.
• Collaborate with coders and CDI staff to provide education and feedback; proactively address issues with CDI management.
• Monitor CMS and OIG publications to ensure compliance with coding, billing, and reimbursement regulations.
• Review third-party payer guidelines to ensure accurate claims charging, coding, and billing.
• Communicate audit results through written reports and presentations to relevant stakeholders.
• Document audit activities and report findings regularly.
• Serve as a resource for hospital departments regarding coding and documentation.
• Conduct CDI audits regarding payor denials when necessary.
• Collaborate with health information management, Revenue Integrity, patient accounting, and other departments to implement compliance solutions.
• Support the Chief Compliance Officer on coding, billing, and reimbursement compliance issues.
• Perform ongoing audits to identify process improvement and education opportunities.
• Deliver detailed ICD-10 training to CDI staff.

General

• Maintain professional development through continuing education and industry engagement.
• Recognize situations requiring supervision and seek appropriate guidance.
• Follow policies, procedures, and safety standards.
• Complete required education assignments annually.
• Work toward achieving goals and objectives and participate in quality improvement initiatives as requested.
• Perform other duties as assigned.