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Grow You: Expand your career horizons with these three hot jobs in CDI—and a leadership mindset

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CDI is a booming profession, with organizations across the country hiring for open positions. But many are stuck in the mindset that the only available options are front-line chart reviewers, or managers/directors who oversee them.

The reality is that the last several years have seen incredible diversification of the CDI role, which means more job opportunities and a chance to carve out a more rewarding career that aligns with your skills and interests.

Here are three jobs to consider in your career path:

  1. CDI informaticist. Data is the future of medicine. Being able to track diagnosis capture by specialty or down to the individual provider level is powerful, and can reveal critical areas of opportunity. For example, a CDI informaticist may drill down to PSI 11 (postoperative respiratory failure rate), producing a report of how often this diagnosis is being reported, and by which specialties, to launch new documentation improvement or quality improvement interventions, or offer targeted education. Or, they may trend sepsis capture from month-to-month and report trends to hospital administration. A CDI specialist with this level of skill and insight will stand apart from their peers, and hospitals are beginning to supplement their staff with informaticists. Some CDI professionals have opted to return to school to pursue advanced training informatics as part of an MSN or other program.
  • Tech savvy: To do this job well you must be comfortable with tech; some organizations have even combined the informaticist role with physician “tech support,” for example helping physicians navigate documentation workflows in EPIC by serving as at-the-elbow support.
  1. Ambulatory CDI specialist. CDI is increasingly moving outside of hospital walls to the capture of chronic disease burden in outpatient settings, for the purposes of Hierarchical Condition Code (HCC) capture for Medicare Advantage for example. Some hospitals, especially those that are part of an accountable care organization (ACO) have dedicated outpatient CDI departments. Ambulatory (also referred to as outpatient) CDI contains a significant amount of overlap with inpatient, but with significant differences. Due to the high volume of outpatient encounters some outpatient programs don’t query physicians, but instead focus on providing education to physicians in clinics and practices across a wide geographic area. Many ambulatory CDI programs review records prospectively, scouring for conditions that were documented in an annual wellness visit a year prior but may need to be redocumented for the current visit. After performing the review of the prior record, the ambulatory CDI specialist will send a reminder to the physician to review these conditions to determine if they should be documented, in effect “teeing up” that record for the upcoming 20-minute visit.
  • Be flexible: Being innovative, adaptable, and able to work autonomously are traits you’ll need to work in this setting where best practices are still being explored. You’ll also need to brush up on diagnoses that aren’t typically a focus in the inpatient setting but can impact risk scores, particularly chronic diseases.
  1. Denials specialist. As the volume of denials increases, denials management is starting to become a dedicated responsibility in many CDI departments. Many who do the job of denials specialist describe it as akin to detective work, or adopting the mindset of a lawyer. It involves review of the denial letter from the payer, a re-review/deep dive into the denied case to look for clues that the auditor may have missed (or “looked past” in their eagerness to remove a CC or MCC, even when the clinical support for the diagnosis is plain). It often typically involves writing persuasive appeals letters using Coding Clinic, the Official Guidelines for Coding and Reporting, and the latest clinical literature for support. It can include followup education of clinical staff on common sources of denial or targeted training of coding staff.
  • Next level: Many denials management jobs pay more than frontline CDI reviewers as they require a higher degree of skill, including research skills and compelling writing ability, and have a direct impact on revenue protection. Some of these jobs can be found in consulting companies, as hospitals often outsource this function to firms.

Leaders needed—Grow You

Even if you don’t plan to leave your organization, but are restless in your current position, you can carve out a new role and grow your reach and impact by approaching your manager or director about these positions.

If you’re a director and worry about retaining your staff in this competitive environment, consider building a career ladder that includes denials management or CDI educator as a next step for growth-oriented staff.The term “leadership” has grown a bit cliché/overused these days, but it is shorthand for the willingness to do uncomfortable but important tasks. Ask difficult questions. Take on new responsibilities. Set a good example, and in so doing drive change and growth.Leadership is not always about leading teams of people. Leadership includes leading yourself. Managing your limited time, organizing your day-to-day tasks that must be done, and focusing the lion’s share of your day on the ones that move the needle. It’s also about leading up, tactfully asking your manager or director for help and support, but also offering your services freely to others in need. Which can lift their load and improve overall department performance.

Effective self-leadership will transform you into a good CDI professional, which in time can lead to promotions and the opportunity to lead a team.

But first you must demonstrate you can lead yourself.

Today, more than ever, leadership is needed. Amazing opportunities exist for CDI professionals who want to do more than just review 20-25 charts a day, send 4-5 queries, and turn off the computer. There is a place for this work, of course, but there is also a need for out-of-the-box thinking, roles like those mentioned above.

We sum this up with a simple mantra: Grow You.

See something here that sparks your interest? Want to Grow You? We’ll help you find the career you’ve been looking for. Contact us at Norwood at team@norwood.com.

We love to talk CDI—it’s what we do.

About the author

Brian Murphy is the founder and former director of the Association of Clinical Documentation Integrity Specialists (2007-2022). In his current role as Branding Director of Norwood he enhances and elevates careers of mid-revenue cycle healthcare professionals.

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