Clinical Documentation Nurse Specialist
Job Posting for Clinical Documentation Nurse Specialist at J. Morrissey
Clinical Documentation Nurse Specialist
INDI
- Hands on Clinical Documentation Nurse who has leadership experience with Coding Criteria for admissions. Audits records regularly and supports team with quality improvement and training guidance.
- Ensures the DRG and Patient Medical Record documentations are accurate. Audits improve efficiency, achieve accurate reimbursement, and reduce administrative burdens for both clinicians and CDI teams.
- Strives to improve the inpatient coding, DRG methodologies, risk adjustment, quality indicators, comorbidity indices, clinical documentation integrity and coding compliance within an acute care setting.
- Works with Coding team and Manager’s collaboratively along with other clinical staff for quality improvement initiatives.
- Strong ICD-10-CM/PCS coding and DRG experience. Strong clinical documentation, medical record coding, healthcare billing and revenue cycle management experience.
- Working knowledge of risk-adjusted methodologies (APR DRGs) and quality of care measures (HACs, PSIs)
- Concurrent review, ICD-10-CM/PCS Coding Guidelines and ICD-10-CM/PCS coding updates to distill information in an effort to update and maintain CDI materials and resources.
- Determine subsets for patient admissions to determine priority of admission prior the admission based on the patient’s diagnosis and procedure codes associated with the prior admission and the reason if readmitted.
- Reviews analysts with a list of PPRs by patient, diagnosis related group (DRG) and reason and reviews data with Clinical Teams to reduce readmissions and improve scores and improve level of care.
- Knowledge of official medical coding guidelines, CMS, and private payer regulations related to the Inpatient Prospective Payment System
- An ability to analyze and interpret medical record documentation and formulate appropriate physician queries
- An ability to benchmark and analyze clinical documentation program performance
- Prior Case Management experience also preferred.
- Registered Nurse in the State of Connecticut
- BSN
- Team Lead Experience
- Acute Care Setting
- Experience with EPIC and 3M 360
- CCDS Certification or similar
- AHIMA
- Work Model: Hybrid (2 days on site/3 remote)
- Location: Centrally located in Connecticut
- Recruiter Contact: Krisha Morander | KrishaM@jmorrissey.com
- Salaried position with dynamic benefits package
INDI
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