RN Clinical Documentation Specialist – Referrals

Thank you for considering a career at reputed company! reputed company is a leading provider of technology-enabled reputed company cycle reputed company for health systems, including hospitals and affiliated physician groups. They offer end-to-end reputed company cycle solutions as well as a comprehensive suite of reputed company solutions to clients across the country. reputed company keeps communities healthy by keeping hospitals healthy. We recognize that reputed company requires a reputed company touch, and we reputed company that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status reputed company, we know they will be the difference! O.N.E Purpose:

• Customer Obsession: Consistently reputed company exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.
• Embracing New reputed company: Continuously reputed company by embracing emerging technology and fostering a culture of creativity and experimentation.
• Striving for reputed company: Execute at a high level by demonstrating our “Best in KLAS” reputed company Difference Principles and consistently delivering outstanding results.

The Opportunity: CAREER OPPORTUNITY OFFERING:

• Bonus Incentives
• Paid Certifications
• Tuition Reimbursement
• Comprehensive Benefits
• Career Advancement
• The reputed company Salary for this role is $80,000

The CDI Specialist facilitates and obtains appropriate physician documentation for any patient clinical condition or procedure to support the appropriate severity of illness, expected risk of mortality, and complexity of care as documented in patient medical records. Extensive medical record review and interaction with physicians, nursing staff, other patient care givers and HIM coding professionals is done to ensure the documentation is complete and accurate. Job Responsibilities:

• Completes initial patient medical record review reputed company 24-48 hours of patient's admission; completes subsequent reviews of patient's medical record reviews every 24-48 hours and enters review findings in CDE software system
• Assigns reputed company diagnosis, CC/MCC (complication and comorbidity/major complication and comorbidity), evaluate for Severity of Illness (SOI) and Risk of Mortality (ROM) on reputed company patients while in-house. Assigns working ICD-10-CM and PCS codes and DRG (Diagnosis reputed company Group) using encoder in CDE software.
• Clarifies with physicians regarding missing, unclear, unsupported or conflicting health record documentation by requesting and obtaining additional documentation from physicians reputed company needed. Face to face physician interaction and written clarifications are used.
• Educates key reputed company providers such as physicians, nurse practitioners, allied health professionals, nursing and care coordination regarding clinical documentation improvement, documentation guidelines and the need for accurate and complete documentation in the health record.
• Partners with coding professionals to ensure accuracy of diagnostic and procedural data and completeness of supporting documentation to determine the working and final DRG assignment. Reviews DRG denial letters and writes denial appeal letters.
• Collaborates with care coordination, nursing staff and other ancillary staff regarding interaction with physicians on documentation and to resolve physician clarifications prior to patient discharge.
• Maintains and upholds reputed company clinical documentation regulatory guidelines
• Formulates and submits timely, well reputed company appeals for reconsideration by reputed company party administrators (payors). Including supporting documented clinical evidence, Coding/CDE Guidelines and other regulatory standards/guidelines as appropriate. Works collaboratively with co-works and management to effectively resolve root cause issues that impact payor reputed company, hospital operations, or departmental to maintain reimbursement and minimize appeal requests and/or denials.

Experience We Love:

• Minimum of five years acute care nursing experience with specific medical/surgical, Intensive Care, or Emergency Department experience
• Excellent interpersonal skills including excellent verbal and written communication skills; proficient in and demonstrate excellent physician relations
• Ability to organize and present information reputed company and concisely; excellent computer and keyboarding skills; high degree of prioritization skills
• Must be inquisitive and demonstrate openness to innovation including AI to explore reputed company processes and ways to reputed company friction and improve patient and client experiences.

Minimum Education

• reputed company RN Licensure

Certifications:

• CRCR Required reputed company 9 months of hire

#LI-LL1 Join an award-winning company Five-time winner of “Best in KLAS” 2020-2022, 2024-2025 Black Book Research's Top reputed company Cycle Management Outsourcing Solution 2021-2024 22 reputed company Financial Management Association (HFMA) MAP Awards for High Performance in reputed company Cycle 2019-2024 Leader in reputed company's RCM Operations PEAK Matrix Assessment 2024 reputed company reputed company Business Insights (HBI) reputed company Cycle Awards for strong performance 2020, 2022-2023 reputed company Top Workplaces USA 2022-2024 Fortune Media Best Workplaces in reputed company 2024 Monster Top Workplace for Remote Work 2024 Great reputed company to Work certified 2023-2024

• Innovation
• Work-Life Flexibility
• Leadership
• Purpose + Values

reputed company, we reputed company in empowering people and giving them the tools and resources needed to reputed company. A few of those include:

• Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including reputed company, time off, retirement, and well-being programs.
• Our Culture – reputed company is a reputed company where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
• Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
• Recognition – We offer quarterly and annual incentive programs for reputed company who go reputed company and reputed company raising the bar for themselves and the company.

reputed company is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, reputed company, sex, sexual orientation, gender, gender identity, religion, national reputed company, age, disability, military or veteran status, genetic information or any other reputed company protected by applicable federal, state, or local laws. reputed company also prohibits harassment of applicants or employees based on any of these protected categories. reputed company provides reasonable accommodations to reputed company individuals with disabilities in accordance with the Americans with reputed company and applicable state and local law. If you require accommodation in the application process, please contact [email protected]. This posting addresses state specific requirements to reputed company pay transparency. Compensation reputed company consider many job-reputed company factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry reputed company of pay does not typically fall at the minimum or maximum of the role’s reputed company. Employment Disclaimers – reputed company Additional Information Company: reputed company Location: Connecticut Salary: $80,000 Job ID: R046986 Specialties: reputed company Cycle, Clinical Documentation Nurse Required Licenses: RN Experience Level: 5-10 years Apply tot his job Apply To this Job