Clinical Documentation Improvement: DRG Integrity & Denials

Capital Health; Princeton (NJ); On-site; USD 54,277 - 70,905; Full time

Benefits offered by this job

Medical Plan

Dental Plan

Vision Plan

Flexible Spending Account

Retirement Savings Plan

Paid Time-Off Program

Job summary

Capital Health in Princeton, NJ, seeks an experienced Clinical Documentation Improvement Specialist to oversee clinical documentation reviews and prevent DRG downgrades. The role requires a graduate nursing degree and at least three years of CDI experience. Responsibilities include documentation analysis, collaboration with clinical staff, and support for accurate DRG assignment. The position comes with a competitive pay range of $39.40 - $51.47 per hour, plus a comprehensive benefits package.

Qualifications

• 3 years' CDI experience required.
• Experience with DRG validation and clinical validation audits preferred.
• Registered Nurse - NJ required.

Responsibilities

• Review inpatient cases for DRG downgrade assessments.
• Identify documentation gaps for DRG assignment.
• Collaborate with clinical teams for DRG defense.

Skills

Expert knowledge of DRG methodology

Strong familiarity with payer audit firm methodologies

Strong written and verbal communication

Collaborative skills with clinical and denial management teams

Education

Graduate of an accredited school of nursing

Current CDI certification (CCDS, CCDS-O, CDIP, or equivalent)

Tools

Electronic medical records

CDI tools

Microsoft Office

Job description

Capital Health in Princeton, NJ, seeks an experienced Clinical Documentation Improvement Specialist to oversee clinical documentation reviews and prevent DRG downgrades. The role requires a graduate nursing degree and at least three years of CDI experience. Responsibilities include documentation analysis, collaboration with clinical staff, and support for accurate DRG assignment. The position comes with a competitive pay range of $39.40 - $51.47 per hour, plus a comprehensive benefits package.