Director Clinical Documentation Improvement Resume Example

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Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • Home: (555) 432-1000
  • Cell:
Professional Summary

Results-driven Director of Clinical Documentation Improvement and Doctor of Medicine specializing in Revenue Cycle and Patient care, offering 7 year background to growing CDI program. Expert in all aspects of Revenue cycle with success in developing strong projects within electronic medical record to support appropriate reimbursement and patient care

  • Issues resolution
  • Script review and revision
  • Strategies and goals
  • Business Administration
  • Rules and regulations
  • Budgeting
  • Staff management
  • Staff development
  • Financial management
Work History
Director, Clinical Documentation Improvement, 06/2013 to Current
BronxCare Health SystemCity, STATE,
  • Develops and manages Clinical Documentation functions and activities at Bronx Care Health System
  • Based upon strategic corporate initiatives and hospital goals develop Divisional Clinical Documentation work plan annually and report completed activities to CEOs, CMOs, CMIOs, CNOs, CFOs and Quality leaders
  • Identify staff development opportunities, perform management and evaluation for all Clinical Documentation staff, perform timekeeping duties, responsible for screening and hiring of new employees
  • Manages and oversees daily operational Clinical Documentation hospital-based activities, data collection, analysis and reports. Participates on committees and presents results of studies, trends, and activities as necessary to demonstrate improvement in clinical documentation processes
  • Malnutrition Documentation Improvement Initiative (MDii) - Increases benchmark of Adult Malnutrition by 215 percent. Prevalence rate for Adult Malnutrition changed from 1.8% to 6% (an estimated discharge volume of non-neonatal and non-maternal discharges in 2018). Revenue generated: $9,840,000
  • HIV Project - Over $527,000 improvement, $6,455 increase in revenue per patient by identifying correct AIDS patient with "live time" visual screen for every admitted patient on floors. Visual screen identifies nadir and current absolute CD4 cells as well as current viral loads
  • Debridement Project - Created compliant note which captures details based on CMS guidelines. Total reimbursement gain: $500,837 per annum, 44% change per procedure
  • Complex Pneumonia - Very close to achieving NYC benchmark of 21% complex pneumonia, started with 3 percent and currently reporting 16%. Approximate gain of $4,732 and 4 additional days of groupers length of stay
  • Critical Care Unit Projects: Functional Quadriplegia, Pressure ulcers and Acute postoperative pulmonary insufficiency
  • Current project - BronxCare will be leader to accurately and identify acute post-op kidney injuries thru latest tool which analyze baseline of Serum Creatinine and Glomerular Function test
  • Drove profit increases by leveraging market knowledge and natural leadership talents
  • Aided senior leadership during executive decision-making process by generating daily reports to provide data for consideration of corrective actions and improvements
Director, Quality Assurance – Surgery, 10/2017 to Current
BronxCare Health SystemCity, STATE,
  • Collaborates with hospital and physician organization leaders to envision, develop, and implement organization’s quality and patient safety plan
  • Establishes quality measurement and improvement activities, including methods to track implementation of action plans following site surveys and critical events reviews
  • Coordinates and manages Core Measures reporting and other functions
  • Oversees regulatory readiness, quality measurement, public reporting, and pay-for-performance programs and initiatives, holding staff and departments accountable for achieving performance goals
  • Noticeable Projects: ADVANCE COLON BUNDLE AND EARLY RECOVERY AFTER SURGERY - Decreased Surgical site infections of colon from 16 percent to "Zero" and sustaining for last two years. Automate removal order foe Foley after 48 hrs. to reduce CAUTI - Catheter associated Urinary Tract Infection
DRG VAlidator - Remote , 06/2016 to Current
NewYork-Presbyterian HospitalCity, STATE,
  • Sites: New York-Presbyterian Lower Manhattan Hospital & Weill Cornell Medical Center - Works as a vendor for JBK associate Inc
  • Analyzes and Audits Claims - Integrates medical chart coding principles, clinical guidelines and objectivity in performance of medical audit activities. Draws on advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate conclusions
  • Effectively Utilizes Audit Tools - Perform remote review of selected inpatient discharges from Client’s editing program for DRG validation purposes utilizing Client’s encoder software, clinical information system and abstracting system
  • Provides education - Collaborate with coding and appeal professionals to review selected health records, explain clinical issues, and assist in developing appropriate and compliant clinical documentation queries and denial management
M.D.: Medicine, Expected in 06/2007
Jinnah Medical & Dental College - Pakistan ,
  • Certified Coding Specialist - AHIMA
  • Certified Documentation Improvement Practitioner -AHIMA
  • Certified Clinical Documentation Specialist - ACDIS

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Resume Overview

School Attended
  • Jinnah Medical & Dental College
Job Titles Held:
  • Director, Clinical Documentation Improvement
  • Director, Quality Assurance – Surgery
  • DRG VAlidator - Remote
  • M.D.