RN, Clinical Documentation Integrity

denverhealth; Denver (CO); On-site; USD 83,000 - 128,000; Full time

Benefits offered by this job

Tuition assistance

Retirement contributions

Health coverage

Paid time off

Parental leave

Job summary

Denver Health is seeking a mission-driven RN, Clinical Documentation Integrity to join our Revenue Integrity team. The role involves concurrent and retrospective reviews to improve documentation quality and compliance, educating providers, and collaborating with Coding, HIM, and Compliance to ensure accurate patient records.

Qualifications include an Associate's Degree and 4-6 years of nursing experience in a hospital setting, with RN license (DORA) required.

Qualifications

• Associate's Degree required for nursing practice.
• 4-6 years of hospital nursing experience with documentation focus.
• RN license (DORA) required and CMS knowledge preferred.

Responsibilities

• Conduct concurrent and retrospective reviews of patient records for documentation accuracy.
• Educate providers on documentation accuracy, specificity, and compliance.
• Provide feedback on audit results to providers and teams.
• Collaborate with Coding, HIM, Patient Safety, and Compliance to ensure accurate documentation.
• Stay current on ICD-10, CMS rules, and billing guidelines.

Skills

Clinical Documentation Integrity

Nursing experience

Communication with physicians

CMS knowledge

Education

Associate's Degree Required

Tools

Microsoft Office Excel

SharePoint

Job description

We are recruiting for a mission-driven RN, Clinical Documentation Integrity to join our team! We're with you for life's journey. At Denver Health, purpose isn't just something we believe in-it's something we live every day, for life's journey.

Our Values

Respect | Belonging | Accountability | Transparency

Department

REVENUE INTEGRITY

Job Summary

Under general supervision performs concurrent and retrospective reviews as requested by the Clinical Documentation Integrity Manager or Director. Responsible for selected assignments based on internal or external department requests. Responsible for educating providers regarding documentation specificity, accuracy, compliance and are permitted to query physicians as deemed necessary. Collaborates with Coding, Health Information Management (HIM), Patient Safety and Quality, Enterprise Compliance Services and other departments to promote the common goal of obtaining accurate documentation in the patient's record. Must participate in continuous education on ICD-10, clinical medicine, Center of Medicare and Medicaid (CMS) and other billing carriers, as well as coding guidelines and policies.

Essential Functions

• Concurrent and/or retrospective review of designated inpatient, outpatient, and ambulatory patient records to assess for accuracy, specificity, and compliance of provider documentation. (20%)
• Tracking audits performed and audit results obtained in order to provide meaningful data to key stakeholders. (20%)
• Educating providers regarding documentation accuracy, specificity, and compliance with rules and regulations. (20%)
• Providing pertinent feedback to providers on audit results as necessary. (20%)
• Working collaboratively with Coding, Health Information Management (HIM), Patient Safety and Quality, Enterprise Compliance Services, and other departments to promote the common goal of obtaining accurate documentation in the patient record. (20%)

Education

Associate's Degree Required

Work Experience

4-6 years Six years of experience as a nurse in a hospital environment Required and 4-6 years Three of the six years with the appropriate level of experience in one or a combination of the following medical documentation related function: clinical coding, case management, DRG coordination, physician education, Medicaid/Medicare reimbursement. Required

Licenses

RN-Registered Nurse - DORA - Department of Regulatory Agencies Required

Knowledge, Skills and Abilities

• Must be able to demonstrate knowledge of the pathophysiology of the disease process.
• Must be able to demonstrate clinical expertise in areas of urgent/emergent, medical/surgical, obstetrical, pediatric, and ambulatory care.
• Must be able to communicate and interact tactfully with physicians and other professionals by expressing ideas clearly and concisely and addressing audiences effectively.
• Ability to read and interpret professional journals, financial reports, and legal documents as necessary.
• Ability to define problems collects and summarizes data, establish facts and draw conclusions.
• Possesses knowledge of clinical documentation and coding concepts, DRG assignments, Inpatient Prospective Payment System (IPPS) and CMS rules and regulations.
• Must also be able to demonstrate knowledge including but not limited to, value-based purchasing, bundled payments, accountable care organizations and readmission reduction program.
• Microsoft Office Excel and SharePoint
• Variety of documentation and coding programs.

Shift

Days (United States of America)

Work Type

Regular

Salary

$82,500.00 - $127,900.00 / yr

Benefits

At Denver Health, we take care of the people who take care of our community. Our benefits are built to support your life, your family, and your future - with generous paid time off, fully paid parental leave, exceptional retirement contributions, comprehensive health coverage, and nationally recognized well-being programs. We invest in your growth through tuition assistance, career advancement pathways, and professional development - while also offering meaningful financial advantages through loan forgiveness eligibility and employer contributions. When you join Denver Health, you're joining a mission-driven organization that invests in you.

Here is a small list of our benefit programs:

• Paid time off starting at 28 days per year, inclusive of vacation, personal/sick, and 7 Holidays
• 100% paid parental leave up to 6 weeks
• Immediate eligibility for retirement plans with employer contribution up to 9.5%
• Generous medical, dental, vision plans in addition to employer paid disability and life insurance.
• Comprehensive well-being programs including on-site employee fitness center located on Denver Health main campus and nationally recognized RESTORE Center
• Free RTD EcoPass (public transportation)
• Childcare discount programs & exclusive perks on large brands, travel, and more
• Tuition reimbursement & assistance
• Education, coaching, and professional development opportunities through the Workforce Dev