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St. Luke's University Health Network
Overview
The RN Clinical Review Appeals Specialist conducts retrospective reviews of patient medical records and claims data to ensure accurate coding and DRG assignment. They develop appeal arguments and facilitate communication with various stakeholders to resolve documentation and coding issues.
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Compensation
Salary not listed
Posted
7 days ago
Mercy Cedar Rapids
The Clinical Documentation Specialist reviews medical records to ensure accurate reflection of patient conditions and services provided. They collaborate with physicians and the coding team to resolve documentation issues and manage denials related to medical necessity.
8 days ago
Conifer Health Solutions
Review medical records to ensure accurate clinical documentation, MS-DRG assignment, and severity of illness representation. Collaborate with physicians and the care team to resolve documentation queries and provide education on coding guidelines.
11 days ago
NewYork-Presbyterian Hospital
The Surgical Outcomes Coordinator will oversee and maintain surgical quality platforms while collaborating with the surgical team to identify opportunities for clinical improvement. They are responsible for abstracting designated surgical cases for national quality programs and participating in peer review and research initiatives.
$81 / HOUR
24 days ago
Ansible Government Solutions
The Medical Records Technician will review and analyze health records to identify documentation improvement opportunities and generate queries to healthcare providers for clarification. They will also develop standard operating procedures and participate in performance improvement activities.
1 month ago
GBMC HealthCare
The CDI Nurse will collaborate with coding and clinical teams to enhance diagnosis coding accuracy for risk adjustment and reimbursement optimization across outpatient practices. Key duties include leading pre-visit documentation reviews and contributing to the strategic maintenance of accurate patient problem lists in the EMR.
$73,466 - $126,056 / YEAR
Xpress Wellness Urgent Care
The Certified Coding Specialist abstracts or accurately codes procedures from medical records to ensure optimal reimbursement while maintaining compliance with all regulatory guidelines, including CPT and ICD10 standards. Duties involve managing charge review queues, accurately posting codes, consulting with providers for documentation clarity, and providing education on documentation improvement.
UHS
Provides clinically based concurrent and retrospective reviews of inpatient medical records to evaluate documentation and utilization of acute care services. Facilitates accurate physician documentation to reflect patient severity of illness and risk of mortality for quality reporting and reimbursement.
Genesis Administrative Services LLC
The Clinical Documentation Improvement Specialist oversees and ensures the accuracy of High Nursing Facility Level (HNF) clinical documentation for regulatory compliance and reimbursement. They collaborate with interdisciplinary teams to audit charts, educate staff, and manage acuity level communication with Managed Care Organizations.
The Clinical Documentation Improvement Specialist is responsible for overseeing and ensuring the accuracy of clinical documentation for regulatory compliance and reimbursement. They collaborate with interdisciplinary teams to audit charts, monitor resident conditions, and educate staff on documentation standards.
The Clinical Documentation Improvement Specialist oversees clinical documentation to ensure accuracy, regulatory compliance, and proper reimbursement for resident care. They collaborate with interdisciplinary teams to audit charts, educate staff, and manage acuity levels according to state guidelines.
Beth Israel Lahey Health
The CDI Specialist II reviews inpatient medical records to ensure clinical accuracy, completeness, and appropriate DRG assignment. They collaborate with physicians and the coding team to resolve documentation queries and improve quality outcomes.
$102,000 - $158,392 / YEAR
2 months ago
Northwestern Memorial Healthcare
The specialist reviews medical records to abstract and assign appropriate CPT, ICD-10, and HCPCS codes for professional services, focusing on complex encounters like anesthesia and surgical procedures, aiming for a minimum of 95% accuracy. This role also involves training providers on documentation, resolving coding edits, reconciling charges, and collaborating with operational areas to address claim issues and denials.
$26 - $36 / HOUR
University of Mississippi Medical Center
The specialist supports and reviews inpatient medical records to improve documentation quality, completeness, clinical severity, and accuracy for specific departments, obtaining appropriate documentation through extensive interaction with physicians and the healthcare team. Responsibilities include reviewing charts within 24-48 hours of admission, assigning working DRGs, identifying comorbidities, and communicating documentation improvement opportunities clearly to providers.
NOR Healthcare Systems
The CDI Specialist conducts concurrent and retrospective reviews of inpatient medical records to ensure documentation reflects medical necessity and quality of care. They work closely with medical staff to resolve documentation ambiguities and facilitate accurate coding and reimbursement.
$93,800 - $128,950 / YEAR
3 months ago
Exceptional Healthcare Inc.
The specialist will review inpatient medical records concurrently and retrospectively to find documentation gaps and create compliant, non-leading physician queries to clarify clinical information. They will also educate providers on documentation best practices and monitor key quality and reimbursement metrics.
Baptist
The primary role involves coding diagnoses and procedures from patient records for reimbursement, research, and statistical data generation. This position also requires performing daily feedback and education for providers, staff, and patients, and assisting with the education of current coding staff.
4 months ago
Hollywood Presbyterian
The Clinical Documentation Improvement Specialist is responsible for ensuring the accuracy and completeness of medical record documentation. This includes performing record reviews, initiating provider queries, and collaborating with various teams to support quality outcomes and accurate coding.
