Garnet Health

Established in 2002, Garnet Health is a leading healthcare system serving the Hudson Valley and Catskills regions of New York. It offers comprehensive services,

Clinical Documentation Integrity Manager

Location

United States

Posted

5 days ago

Salary

$80.1K - $100.1K / year

Seniority

Lead

No structured requirement data.

Job Description

Clinical Documentation Integrity Manager

Garnet Health

Role Description Under the direction of The Administrator, Coding & Clinical Documentation Improvement and Patient Access, the Manager of Clinical Documentation Integrity (CDI) and DRG Denials is responsible for the day-to-day operation of the CDI department and DRG Denials appeals process. The Manager will: - Develop, implement, and evaluate processes, policies, and procedures related to clinical documentation improvement for all Garnet Health hospitals. - Lead CDI functions and oversee the day-to-day work in the department. - Ensure that reviews of the patient’s medical data are conducted to assess appropriateness and medical necessity for admission and continued stay. - Facilitate improvement in the overall quality, completeness, and accuracy of medical record documentation. - Evaluate denials and work closely with the outcomes manager and coding denial coordinator to oversee and write compelling, factual arguments when warranted to the third parties denying claims. Join the Garnet Health team and let your excellence shine. Compensation for the role is $80,106-$100,133 USD per year. Fully remote from the following states: Pennsylvania; Florida; South Carolina; North Carolina; Texas. Garnet Health System provides a compensation range to comply with the New York State law on Salary Transparency in Job Advertisements. The range or contractual rate listed does not include bonuses/incentives, differential pay, or other forms of compensation or benefits. When determining a team member’s compensation and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity). Qualifications - Bachelor's Degree in Nursing - Minimum of 3-5 years of progressive experience in an acute care hospital (larger than 100 beds) - Minimum of five years of experience in the CDI industry - Strong knowledge of ICD 10 diagnosis coding, CPT Coding guidelines, and DRG-based reimbursement knowledge - Exceptional ability to communicate effectively with physicians and other clinical professional staff - Knowledge of DRG and Coding appeal process Requirements - Certified Clinical Documentation Specialist (CCDS) credentialed within 6 months - Current license to practice as a Registered Professional Nurse in New York State required - Travel to multiple facilities is required Working Conditions - Environmental Demands and Exposure to Hazards: Works in a clean, well-lighted, heated, or ventilated facility. No routine exposure to hazards. - Physical Demands: Demonstrates physical and functional ability to perform full anatomical range of motion to accomplish tasks. Evidence of visual and aural acuity and finger and hand dexterity to operate computer and office equipment. Can withstand long periods of sitting, standing, and/or constant walking. Ability to lift 10 lbs. - Mental Demands: Ability to foster collaborative relationships, work well under pressure, organize and synthesize new information, and prioritize tasks. Possesses critical thinking, analytical skills, and flexibility. Ability to multi-task. Required detailed attention to work in an environment where interruptions cannot be controlled. Demonstrates sensitivity to customer needs and expectations. May be subject to irregular hours including evenings or potentially weekends to participate in operational and community events as necessary. Workplace Type Hybrid

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