RN Nurse Clinical Documentation Improvement Specialist

R1 RCM Holdco Inc.; United States; Presencial; USD 52.000 - 98.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Competitive benefits package

Annual bonus eligibility

Descripción de la vacante

R1 RCM Inc. is seeking a Clinical Documentation Improvement (CDI) Specialist with an active US RN license and front line CDI experience in an acute care hospital.

You will lead physician queries, educate staff on documentation and coding guidelines, and collaborate with cross-functional teams to ensure accurate reflection of CMI, LOS, and resource use. The role focuses on improving coding accuracy, DRG assignment, and compliance, with emphasis on staying current with CMS changes and CDI

Formación

• Active US RN license required.
• Front line CDI experience in an acute care hospital.
• Three to five years of recent clinical work in medical-surgical, ICU, telemetry or ED.

Responsabilidades

• Initiates physician interaction when documentation is ambiguous, missing, or conflicting to obtain accurate coding.
• Educates physicians and staff on documentation, coding guidelines, and reimbursement policies.
• Uses hospital coding rules, regulations, and guidelines to assign DRG and ensure highest specificity.
• Collaborates with coders, auditors, and quality teams to resolve documentation issues and improve coding.
• Stays updated on clinical documentation standards and regulatory requirements.
• Conducts focused reviews in Mortality, PSI, and other identified CDI projects.

Conocimientos

CDI practices

RN license

Front line CDI experience

Acute care hospital

Educación

Associate’s Degree in Nursing

Bachelor’s Degree in Nursing preferred

Herramientas

EMR platforms

CDI platforms

Descripción del empleo

At R1, we’re transforming how healthcare works by combining nearly two decades of revenue cycle expertise with advanced technology, including analytics, AI, intelligent automation and workflow orchestration. We pair that technology with the irreplaceable expertise of our people to help hospitals, health systems and medical groups improve financial performance, simplify administrative complexity and create better experiences for patients and providers.

All Together Better defines our culture and the way we work. We’re a diverse, global team united by a shared mission to make healthcare work better for all. Across technology, operations and support functions, our people bring deep expertise, empathy and ingenuity to the work we do. Here, collaboration fuels progress, adaptability sparks innovation and every voice can help shape what’s next for R1 and the future of healthcare.

Compensation for this role is expected to be approximately $114,000 annually.

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems, and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration.

To thrive in this role, you must have the following knowledge:

• - Highly skilled in CDI practices, coding, and documentation requirements related to quality outcomes, evaluation of medical record data for accuracy and reimbursement; self-motivated to stay abreast of CMS rules and regulations and incorporate those changes into daily practice.
• - Front Line CDI experience in an acute care hospital
• - Have an active RN license with experience in: ICU, Med surge, telemetry, or ED.

Here’s what you will experience working as a Clinical Documentation Improvement (CDI) Specialist:

• - Initiates physician interaction when ambiguous, missing, or conflicting information is in the medical record, through the physician query process and/or participation in rounding with the physicians by requesting additional documentation for correct coding and compliance necessary for accurate reflection of CMI, LOS, and optimal resource utilization.
• - Educates physicians and other staff on documentation requirements, coding guidelines, and reimbursement policies
• - Utilizes Hospital coding code set, policies and procedures, Federal and State coding reimbursement guidelines, and application of the Coding Clinic Guidelines to assign working DRG, reviewing patient records throughout hospitalization that have been identified as focus DRG by regulatory agencies or the facility to ensure the codes are reported at the highest specificity.
• - Collaborates with coders, auditors, quality improvement teams, and other stakeholders to resolve documentation issues and improve coding accuracy
• - Stays updated on the latest developments and changes in clinical documentation standards, coding rules, and regulatory requirements
• - Conducts focused reviews in areas identified by CDI leadership: Mortality reviews, PSI reviews, as well as other identified projects

Required Qualifications

• - Associate’s Degree in Nursing (Bachelor’s Degree in Nursing is preferred)
• - An active US RN license is required
• - Must have front line CDI experience in an acute care hospital
• - Three to five years of recent clinical work experience in the medical-surgical area, ICU, telemetry, and or emergency department
• - Knowledge or experience in electronic medical records (EMR) platforms and CDI platforms

For this US-based position, the base pay range is $52,025.00 - $97,528.69 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.

This job is eligible to participate in our annual bonus plan at a target of 5.00%

The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.

Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a competitive benefits package.

R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.

If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.

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To learn more, visit: R1RCM.com

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