RN Nurse, Clinical Documentation Improvement Specialist

🔥 4 minutes ago

🏈 Alabama, Kentucky, +4 more states – Remote

infoinfo

💵 $52k - $97.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥📝 Medical Writer

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Logo of R1 RCM

R1 RCM

10,000+ employees

Founded 2017

💼 Consulting

📦 Logistics

🏥 Healthcare

💰 Private Equity Round on 2024-07

Consulting • Logistics • Healthcare

R1 RCM is a leading provider of revenue cycle management solutions for the healthcare industry. With an emphasis on maximizing financial performance and optimizing patient care, R1 offers a comprehensive platform that integrates data analytics, intelligent technologies, and deep expertise in revenue cycle management. The company assists healthcare providers—ranging from hospitals and health systems to physician and specialty care practices—in capturing revenue opportunities, improving payer and patient cash flows, and ensuring compliance with government regulations. R1 is committed to driving cost reductions and revenue improvements while enhancing the patient experience. Their suite of services includes revenue recovery, clinical integrity, and regulatory navigation, making them a trusted partner for many top healthcare providers.

📋 Description

• Conduct clinically based concurrent and retrospective reviews of inpatient medical records • Evaluate clinical service documentation and identify opportunities to improve medical record documentation • Conduct mortality reviews, PSI reviews, and other focused reviews identified by CDI leadership • Facilitate and obtain appropriate physician documentation supporting severity of illness, expected risk of mortality, and complexity of care • Initiate physician interaction through the physician query process and/or participation in physician rounding • Educate physicians and other staff on documentation requirements, coding guidelines, and reimbursement policies • Assign working DRGs and review patient records throughout hospitalization to ensure codes are reported at the highest specificity • Collaborate with coders, auditors, quality improvement teams, and other stakeholders to resolve documentation issues and improve coding accuracy • Participate in documentation improvement initiatives and formal and informal education plans for providers and the CDI team • Stay updated on clinical documentation standards, coding rules, and regulatory requirements

🎯 Requirements

• Associate’s Degree in Nursing required • Bachelor’s Degree in Nursing preferred • An active US RN license is required • Front line CDI experience in an acute care hospital • Three to five years of recent clinical work experience in the medical-surgical area, ICU, telemetry, and/or emergency department • Knowledge or experience in electronic medical records (EMR) platforms and CDI platforms • Highly skilled in CDI practices, coding, and documentation requirements related to quality outcomes, medical record data accuracy, and reimbursement • Ability to stay abreast of CMS rules and regulations • Clinical experience in ICU, medical-surgical, telemetry, or ED • Knowledge of hospital coding code sets, policies and procedures, federal and state coding reimbursement guidelines, and Coding Clinic Guidelines

🏖️ Benefits

• Annual bonus plan at a target of 5.00% • Competitive benefits package • Opportunities to learn, collaborate across groups, and explore new career paths • Opportunity to contribute, think boldly, and create meaningful work • Reasonable accommodation support during the application process

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