Remote RN: Clinical Documentation & Revenue Integrity

Ensemble Health Partners; Northern (KY); Hybrid; USD 72,000 - 88,000; Full time

Benefits offered by this job

Bonus incentives

Paid certifications

Tuition reimbursement

Comprehensive benefits

Career advancement

Job summary

Ensemble Health Partners seeks an experienced Revenue Cycle Specialist RN to support clinical documentation improvement and coding processes. This remote role requires strong nursing background, certified coder focus, and collaboration with physicians and care teams to optimize DRG accuracy.

You will review records, assign diagnoses, explain clarifications, and help prepare appeals, with opportunities for certification reimbursement and career growth.

Qualifications

• Minimum of five years acute care nursing experience with medical/surgical, ICU, or ED background.
• Excellent verbal and written communication and physician relations.
• Strong ability to organize and present information clearly and concisely; proficient computing.
• Open to innovation including AI to improve processes and patient experiences.

Responsibilities

• Completes initial patient medical record review within 24-48 hours of admission.
• Assigns diagnoses, CC/MCC, evaluates SOI and ROM for patients while in-house.
• Codes with ICD-10-CM/PCS and DRG using encoder in CDE software.
• Requests missing or unclear documentation from physicians as needed.
• Educates providers on documentation guidelines and CDI importance.
• Collaborates with coding to ensure data accuracy and DRG assignments.
• Writes DRG denial letters and appeal letters as needed.
• Coordinates with care teams to resolve physician clarifications before discharge.
• Maintains compliance with clinical documentation regulatory guidelines.
• Prepares timely appeals with supporting evidence and regulatory standards.

Skills

Nursing experience

Interpersonal skills

Communication

AI interest

Education

RN Licensure

HFMA CRCR certification within 9 months

Tools

CDE software

DRG coding tools

EMR systems

Job description

Ensemble Health Partners seeks an experienced Revenue Cycle Specialist RN to support clinical documentation improvement and coding processes. This remote role requires strong nursing background, certified coder focus, and collaboration with physicians and care teams to optimize DRG accuracy.

You will review records, assign diagnoses, explain clarifications, and help prepare appeals, with opportunities for certification reimbursement and career growth.