DRG Denial Prevention Clinical Documentation Specialist

MultiCare Health System

About The Position

The Diagnosis Related Grouping (DRG) Denial Prevention Clinical Documentation Specialist (CDS) is responsible for all Hospital Billing Clinical Documentation Integrity (HB CDI) across the system and serves as expert in the field. The incumbent is fully responsible for clinical related DRG denials; writes appeals, collects and analyzes denial data, educates staff on all areas of opportunity and works with CDI leadership across the MultiCare Health System to facilitate knowledge and proficiency in all aspects of HB CDI to assist leadership reach their department annual goals.

Requirements

Bachelor's degree in Nursing, or obtained within three (3) years from the initial date of hire; RN with 25+ years of service may be considered in lieu of education agreement
Registered Nurse license (RN) in Washington State or multi-state licensure endorsement (MSL)
Minimum five (5) years of recent experience as a Clinical Documentation Specialist plus 5 years of Critical Care and/or Emergency Department clinical experience

Nice To Haves

Advanced Degree in Nursing (MSN, PhD, DNP, ARNP) preferred
Utilization Review or coding experience preferred

Responsibilities

responsible for all Hospital Billing Clinical Documentation Integrity (HB CDI) across the system
fully responsible for clinical related DRG denials
writes appeals
collects and analyzes denial data
educates staff on all areas of opportunity
works with CDI leadership across the MultiCare Health System to facilitate knowledge and proficiency in all aspects of HB CDI to assist leadership reach their department annual goals