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Clinical Documentation Integrity Manager- Remote

Role overview

Qualifications

  • Bachelor's Degree in Nursing
  • 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
  • Certified Clinical Documentation Specialist (CCDS) credentialed within 6 months

Responsibilities

  • Oversee the day-to-day operation of the CDI department and DRG Denials appeals process
  • Develop, implement, and evaluate processes, policies, and procedures related to clinical documentation improvement
  • Facilitate improvement in the overall quality, completeness, and accuracy of medical record documentation
  • Evaluate denials and work closely with the outcomes manager and coding denial coordinator to address claim denials effectively

Key facts

Other skills

  • Communication
  • Critical Thinking
  • Analytical Skills
  • Collaboration
  • Time Management

About the company

SWCA Environmental Consultants logo

SWCA Environmental Consultants

Environmental Services

SWCA is a 100% employee-owned environmental firm that offers comprehensive environmental planning, regulatory compliance, and natural and cultural resources management services. Our expanding team of professionals combines scientific expertise with in-depth knowledge of permitting and compliance protocols to achieve technically sound, cost-effective solutions for a full spectrum of environmental projects throughout the U.S. and its territories.

Company details

Company typeLarge
IndustryEnvironmental Services
Company size1001 - 5000

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Job description

Overview:

At Garnet Health, the Hudson Valley’s leading integrated health system, you’ll find the perfect balance of a satisfying career and a rewarding lifestyle. Our focus is on patient-centric care with a collective of visionary leaders and dedicated and caring professionals working as a team to deliver the best for the people we serve. If you’re interested in a health system that’s both growing and award-winning, serving a diverse community that provides the best of both city and rural life, we invite to make your career home with us as a CLinical Documnetaion Specialist on our CDI team at/in Garnet Health Medical Center.

Responsibilities:

Under the direction of The Administrator, Coding & Clinical Documentation Improvement and Patient Access, the Manager of Clinical Documentation Integrity (CDI) and DRG Denials is responsible for the day to day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate processes, policies and procedures related to clinical documentation improvement for all Garnet Health hospitals. The Manager is responsible for leading CDI functions and overseeing the day to day work in the department. The Manager ensures that reviews of the patient’s medical data are conducted to assess appropriateness and medical necessity for admission, and continued stay. The Manager facilitates improvement in the overall quality, completeness, and accuracy of medical record documentation. The Manager will evaluate denials and work closely with the outcomes manager and coding denial coordinator to oversee and write compelling, factual arguments when warranted to the third-parties denying claim.

 

Join the Garnet Health team and let your excellence shine.

 

Salaries shown on independent jobs related websites reflect market averages and do not represent information obtained directly from Garnet Health System. We invite and encourage each candidate to discuss salary / hourly specifics during the application and hiring process. 

 

Compensation for the role is $80,106-$100,133 USD per year.

 

Fully remote from the following states: Pennsylvania; Florida; South Carolina; North Carolina; Texas

 

Garnet Health System provides a compensation range to comply with the New York State law on Salary Transparency in Job Advertisements.   The range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.  When determining a team member’s compensation and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity)

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

 

Required Certification/Registration:
• 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.

 

Working Conditions:
• Environmental Demands and Exposure to Hazards: Works in a clean, well- lighted, heated or ventilated facility. No routine exposure to hazards.
• Physical Demands: 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. Ability to lift 10 lbs.
• Mental Demands: Ability to foster collaborative relationships, to work well under pressure, to organize and synthesize new information, and prioritize tasks. Possesses critical thinking, analytical skills and flexibility. Ability to multi-task. Required detailed attention to work in an environment where interruptions cannot be controlled. Demonstrates sensitivity to customer needs and expectations. May be subject to irregular hours including evenings or potentially weekends to participate in operational and community events as necessary.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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