Revenue Integrity CDI: DRG Defense & Denials

Capital Health (US); Lawrenceville (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

Disability Benefits

Employee Assistance Program

Paid Time-Off Program

Job summary

Capital Health (US) is seeking a Clinical Documentation Specialist in Lawrenceville, New Jersey, responsible for reviewing clinical documentation and addressing DRG downgrades. The ideal candidate will have a registered nursing degree, a CDI certification, and three years of experience in clinical documentation. The role includes collaboration with medical teams and reimbursement practice support, offering a salary range of $39.40 to $51.47 per hour depending on experience and qualifications.

Qualifications

• Three years CDI experience required.
• Experience with DRG validation preferred.
• Strong familiarity with payer and audit methodologies.

Responsibilities

• Review inpatient cases for documentation adequacy.
• Identify documentation gaps impacting DRG assignment.
• Collaborate with teams for documentation clarification.

Skills

DRG methodology knowledge

Clinical documentation clarification

Communication skills

Collaboration with clinical teams

Electronic medical records proficiency

Education

Registered Nurse – NJ

Graduate of an accredited school of nursing

Current CDI certification

Tools

Microsoft Office

Job description

Capital Health (US) is seeking a Clinical Documentation Specialist in Lawrenceville, New Jersey, responsible for reviewing clinical documentation and addressing DRG downgrades. The ideal candidate will have a registered nursing degree, a CDI certification, and three years of experience in clinical documentation. The role includes collaboration with medical teams and reimbursement practice support, offering a salary range of $39.40 to $51.47 per hour depending on experience and qualifications.