DRG Appeals CDI Specialist | Clinical Documentation Expert

Catholic Health; Melville (NY); On-site; USD 130,000 - 170,000; Full time

Benefits offered by this job

Tuition assistance

Pension plan

Job summary

Catholic Health is seeking a highly experienced nurse coder specialist to conduct DRG appeals, validate diagnoses, and manage the full appeals process. You will work with physicians and CDI leadership to improve documentation and ensure accurate coding, contributing to favorable payor outcomes.

Requirements include a BSN, NYS license, and CCDS certification with 5 years of acute hospital experience and 2 years in inpatient CDI, plus proficiency in ICD-10-CM/PCS and Epic Revenue Cycle.

Qualifications

• Bachelor of Science in Nursing (BSN) is required.
• NP or PA license is preferred or required according to role.
• Proficiency with ICD-10-CM/PCS coding guidelines and documentation review.

Responsibilities

• Initiate and manage DRG appeals at all levels.
• Analyze denials and determine coding accuracy based on medical records.
• Collaborate with physicians and CDI leadership to improve documentation.

Skills

MS Office proficiency

Strong communication

Education

BSN

Tools

ICD-10-CM/PCS

Epic Revenue Cycle

Job description

Catholic Health is seeking a highly experienced nurse coder specialist to conduct DRG appeals, validate diagnoses, and manage the full appeals process. You will work with physicians and CDI leadership to improve documentation and ensure accurate coding, contributing to favorable payor outcomes.

Requirements include a BSN, NYS license, and CCDS certification with 5 years of acute hospital experience and 2 years in inpatient CDI, plus proficiency in ICD-10-CM/PCS and Epic Revenue Cycle.