Clinical Documentation Integrity Manager- Remote

Responsibilities

• Directs the day-to-day operations of the CDI department and DRG Denials appeals process.
• Develops, implements, and evaluates processes, policies, and procedures related to clinical documentation improvement for all Garnet Health hospitals.
• Oversees the CDI functions and ensures that reviews of the patient’s medical data are conducted to assess appropriateness and medical necessity for admission and continued stay.
• Facilitates improvements in the overall quality, completeness, and accuracy of medical record documentation.
• Evaluates denials and works closely with the outcomes manager and coding denial coordinator to write compelling, factual arguments when necessary to third-party deniers.

Qualifications

• Minimum Education: Bachelor's Degree in Nursing
• Minimum Experience: Minimum of 3-5 years of progressive experience in an acute care hospital (larger than 100 beds)
• Minimum of five years of experience in the CDI industry
• Strong knowledge of ICD 10 diagnosis coding, CPT Coding guidelines, and DRG-based reimbursement knowledge, required
• Exceptional ability to communicate effectively with physicians and other clinical professional staff
• Knowledge of DRG and Coding appeal process
• Certified Clinical Documentation Specialist (CCDS) credentialed within 6 months
• Current license to practice as a Registered Professional Nurse in New York State required

Physical Requirements

• Travel to multiple facilities is required.
• Works in a clean, well-lighted, heated or ventilated facility.
• No routine exposure to hazards.
• Demonstrates physical and functional ability to perform full anatomical range of motion to accomplish tasks.
• Evidence of visual and aural acuity and finger and hand dexterity to operate computer and office equipment.
• Can withstand long periods of sitting, standing, and/or constant walking.
• Able to lift 10 lbs.