Clinical Documentation Integrity Manager- Remote

Garnet HealthMechanicstown, NY
Hybrid

About The Position

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.

Requirements

  • 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
  • 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.

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.
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