Join Our Team as a Clinical Documentation Specialist Registered Nurse! Join TriHealth as a Clinical Documentation Specialist and partner with interdisciplinary teams to improve documentation accuracy, support quality outcomes, and elevate patient care. Apply today and be part of a team that is passionate about making a difference. We offer career growth opportunities, and a comprehensive benefits package. Location: - Remote - This position requires in‑person attendance for scheduled onsite meetings; therefore, candidates must be located within the greater Cincinnati area. Work Schedule: - Full time - 80 hours per pay period - Day shift - No weekend or holiday rotation required Incentives & Benefits: We offer a comprehensive benefits package, including medical, dental, vision, paid time off, retirement plans, and tuition reimbursement. https://careers.trihealth.com/what-we-offer/benefits Selection Process: As part of the selection process, candidates will be required to complete a pre‑employment assessment test. Candidates who successfully pass the assessment may be considered for the next steps in the selection process, including interviews. Job Requirements: - Bachelor's degree in nursing. Equivalent experience accepted in lieu of degree - Active valid Registered Nurse (RN) license in the state of Ohio. Basic Life Support for Healthcare Providers (BLS) - 5-7 years' experience Clinical in Nursing (Med-Surg, Tele, or ICU) - Basic knowledge of keyboarding and Microsoft office Job Overview: - Concurrently review inpatient medical records for accuracy and completeness of documentation on admission and throughout hospitalization. - Ensure the accuracy and completeness of clinical information within the chart by analyzing for potential gaps in physician documentation through clarifications to improve documentation on principal diagnosis, co-morbidities, present on admission and quality core measures. - Facilitate improvement in clinical documentation through education and extensive interaction with physicians, nursing staff and all other members of the health care team. Systematic development and implementation of educational opportunities for physicians, nursing staff and all other members of the health care team. - Collaboration with coding staff in assuring complete and compliant documentation in all inpatient charts at time of discharge. Participates in the interdisciplinary process to ensure that selected clinical quality indicators are met. - Job Responsibilities: - Facilitates the accurate representation of the severity of illness on TriHealth hospital records by performing admission/continued stay reviews using Clinical Documentation guidelines and standard performance measures. - Processes discharges by updating the Documentation Worksheet to reflect any changes in status, procedures/treatments, and conferring with the physician to finalize diagnoses. - Accurately documents data into CDMP Trak. - Reviews clinical issues with coding staff to assign a working DRG and to resolve discrepancies. - Educates all internal customers on compliant documentation opportunities, coding and reimbursement issues. This standard includes formal presentations at physician meetings nursing and other staff meetings. - Improves documented compliance of selected clinical quality indicators and problems present on admission. Working Conditions: Climbing - Rarely Hearing: Conversation - Consistently Hearing: Other Sounds - Consistently Kneeling - Occasionally Lifting 50+ Lbs. - Rarely Lifting <50 Lbs. - Occasionally Pulling - Frequently Pushing - Consistently Reaching - Frequently Sitting - Rarely Standing - Consistently Stooping - Occasionally Talking - Consistently Use of Hands - Consistently Color Vision - Frequently Visual Acuity: Far - Consistently Visual Acuity: Near - Consistently Walking - Consistently TriHealth SERVE Standards and ALWAYS Behaviors: At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following: Serve: ALWAYS… • Welcome everyone by making eye contact, greeting with a smile, and saying "hello" • Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist • Refrain from using cell phones for personal reasons in public spaces or patient care areas Excel: ALWAYS… • Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met • Offer patients and guests priority when waiting (lines, elevators) • Work on improving quality, safety, and service Respect: ALWAYS… • Respect cultural and spiritual differences and honor individual preferences. • Respect everyone’s opinion and contribution, regardless of title/role. • Speak positively about my team members and other departments in front of patients and guests. Value: ALWAYS… • Value the time of others by striving to be on time, prepared and actively participating. • Pick up trash, ensuring the physical environment is clean and safe. • Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste. Engage: ALWAYS… • Acknowledge wins and frequently thank team members and others for contributions. • Show courtesy and compassion with customers, team members and the community Job Keywords: Registered Nurse, Nurse, Clinical Documentation

Join Our Team as a Clinical Documentation Specialist Registered Nurse! Join TriHealth as a Clinical Documentation Specialist and partner with interdisciplinary teams to improve documentation accuracy, support quality outcomes, and elevate patient care. Apply today and be part of a team that is passionate about making a difference. We offer career growth opportunities, and a comprehensive benefits package. Location: - Remote - This position requires in‑person attendance for scheduled onsite meetings; therefore, candidates must be located within the greater Cincinnati area. Work Schedule: - Full time - 80 hours per pay period - Day shift - No weekend or holiday rotation required Incentives & Benefits: We offer a comprehensive benefits package, including medical, dental, vision, paid time off, retirement plans, and tuition reimbursement. https://careers.trihealth.com/what-we-offer/benefits Selection Process: As part of the selection process, candidates will be required to complete a pre‑employment assessment test. Candidates who successfully pass the assessment may be considered for the next steps in the selection process, including interviews. Job Requirements: - Bachelor's degree in nursing. Equivalent experience accepted in lieu of degree - Active valid Registered Nurse (RN) license in the state of Ohio. Basic Life Support for Healthcare Providers (BLS) - 5-7 years' experience Clinical in Nursing (Med-Surg, Tele, or ICU) - Basic knowledge of keyboarding and Microsoft office Job Overview: - Concurrently review inpatient medical records for accuracy and completeness of documentation on admission and throughout hospitalization. - Ensure the accuracy and completeness of clinical information within the chart by analyzing for potential gaps in physician documentation through clarifications to improve documentation on principal diagnosis, co-morbidities, present on admission and quality core measures. - Facilitate improvement in clinical documentation through education and extensive interaction with physicians, nursing staff and all other members of the health care team. Systematic development and implementation of educational opportunities for physicians, nursing staff and all other members of the health care team. - Collaboration with coding staff in assuring complete and compliant documentation in all inpatient charts at time of discharge. Participates in the interdisciplinary process to ensure that selected clinical quality indicators are met. Job Responsibilities: - Facilitates the accurate representation of the severity of illness on TriHealth hospital records by performing admission/continued stay reviews using Clinical Documentation guidelines and standard performance measures. - Processes discharges by updating the Documentation Worksheet to reflect any changes in status, procedures/treatments, and conferring with the physician to finalize diagnoses. - Accurately documents data into CDMP Trak. - Reviews clinical issues with coding staff to assign a working DRG and to resolve discrepancies. - Educates all internal customers on compliant documentation opportunities, coding and reimbursement issues. This standard includes formal presentations at physician meetings nursing and other staff meetings. - Improves documented compliance of selected clinical quality indicators and problems present on admission. Working Conditions: Climbing - Rarely Hearing: Conversation - Consistently Hearing: Other Sounds - Consistently Kneeling - Occasionally Lifting 50+ Lbs. - Rarely Lifting <50 Lbs. - Occasionally Pulling - Frequently Pushing - Consistently Reaching - Frequently Sitting - Rarely Standing - Consistently Stooping - Occasionally Talking - Consistently Use of Hands - Consistently Color Vision - Frequently Visual Acuity: Far - Consistently Visual Acuity: Near - Consistently Walking - Consistently TriHealth SERVE Standards and ALWAYS Behaviors: At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following: Serve: ALWAYS… • Welcome everyone by making eye contact, greeting with a smile, and saying "hello" • Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist • Refrain from using cell phones for personal reasons in public spaces or patient care areas Excel: ALWAYS… • Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met • Offer patients and guests priority when waiting (lines, elevators) • Work on improving quality, safety, and service Respect: ALWAYS… • Respect cultural and spiritual differences and honor individual preferences. • Respect everyone’s opinion and contribution, regardless of title/role. • Speak positively about my team members and other departments in front of patients and guests. Value: ALWAYS… • Value the time of others by striving to be on time, prepared and actively participating. • Pick up trash, ensuring the physical environment is clean and safe. • Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste. Engage: ALWAYS… • Acknowledge wins and frequently thank team members and others for contributions. • Show courtesy and compassion with customers, team members and the community Job Keywords: Registered Nurse, Nurse, Clinical Documentation

Role Description - Provide timely review and determination of medical claims, including prior authorization, appeals, and/or any other type of medical claims. - Analyze medical records related to the case file. - Review and interpret Local Coverage Determination (LCD), National Coverage Determination (NCD) policies, and other federal regulations. - Apply appropriate regulatory citations, including health plan policies, NCD/LCDs, and/or other regulations to each claim as it relates to the item or issue. - Formulate a narrative decision citing relevant regulatory back-up documentation contained within the medical record. - Adjudicate claim based on the regulations and documentation contained within the medical record. - Attend FHAS and/or client Lunch & Learn sessions and/or general training sessions on site as needed. - Complete IRR surveys in a timely fashion as required by the prime contractor. - Maintain a 97% or higher quality score. Qualifications - Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification through the American Academy of Professional Coders (AAPC) or AHIMA preferred. - Must possess a current, unrestricted State license as a Registered Nurse (RN), Licensed Practical Nurse (LPN), Registered Pharmacist, Occupational Therapist, Physical Therapist, Speech Therapist, or equivalent medical degree as required by contract(s). - 1+ years clinical experience required; coding, utilization, and/or medical chart review preferred. - Professional Coding Certification preferred. - Detailed knowledge of Medicare regulations and guidelines, policies, and payor reimbursements preferred. - Knowledge of CPT, HCPCS, ICD-10 codes and coding guidelines. - Ability to identify Medicare billing and payment irregularities. - Must be able to support review findings by utilizing exceptional analytical, written and oral communication skills. - Ethical, self-motivated and results oriented team player. - Strong analytical, verbal and written communication skills. - Outstanding people skills and ability to effectively review findings/results with management. - Must be proficient with PC and related software programs. - Excellent organizational skills. - Must be a team player. - Limited travel may be required. Requirements - Must be able to remain in the stationary position 95% of the time. - Constantly operate a computer and other office equipment such as telephone. - Regular & predictable attendance is essential for this position. - Remote but need to be local to 18702. - RN preferred but LPN will be considered.

Role Description This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Healthcare Consulting Manager - REMOTE. In this role, you will be at the forefront of driving meaningful changes in the healthcare sector. Your expertise will guide healthcare organizations in optimizing their processes and enhancing the quality of patient care. You will collaborate with a diverse team, leading projects that are instrumental in fostering innovation and achieving better healthcare outcomes. If you are passionate about mentorship and leadership in clinical documentation, this opportunity allows you to make a significant impact in a rapidly evolving environment while furthering your growth and that of your team. - Manage complex multi-workstream projects and oversee junior team members - Analyze data to implement performance improvement and organizational change - Collaborate with team members and clients to align with business objectives - Communicate effectively with project teams and stakeholders - Lead and develop team members through training, supervision, and feedback Qualifications - BA/BS in Nursing with certifications in CCDS required - A minimum of 5 years of acute care hospital experience (ICU, Med/Surg, ER required) - A minimum of 5 years in a clinical documentation integrity role - Relevant experience in a project-based operations performance improvement role within a hospital/clinical setting - Minimum 1 year of experience managing major projects for large, complex healthcare organizations - Strong leadership and management skills aligning to Huron’s core values and competencies - The ability to travel based on client, enterprise, or project needs - Proficiency in Microsoft Office (Word, PowerPoint, Excel) - US Work Authorization required Benefits - Competitive salary range of $140,000 - $200,000 based on experience - Eligibility for annual incentive compensation program - Comprehensive benefits package including medical, dental, and vision coverage - Opportunities for career growth and professional development - Supportive work environment promoting innovation and respect