RN, Clinical Documentation Integrity Specialist

About This Opportunity

We are representing a confidential healthcare revenue cycle management organization in their search for a Remote RN, Clinical Documentation Integrity Specialist. Our client is a nationally recognized leader in their field, supporting hospitals and health systems across the United States.

This remote position requires strong clinical expertise combined with revenue cycle knowledge. You'll review medical records, collaborate with physicians to improve documentation accuracy, and ensure appropriate coding that reflects the true severity of patient conditions.

Responsibilities

• Complete initial medical record reviews within 24-48 hours of patient admission and follow-up reviews every 24-48 hours thereafter
• Assign principal diagnoses, CC/MCC designations, and evaluate Severity of Illness (SOI) and Risk of Mortality (ROM) for all in-house patients
• Assign working ICD-10-CM and PCS codes and DRG classifications using encoder software
• Query physicians through face-to-face interaction and written clarifications when documentation is missing, unclear, unsupported, or conflicting
• Educate physicians, nurse practitioners, nursing staff, and care coordination teams on clinical documentation improvement and documentation guidelines
• Partner with coding professionals to ensure diagnostic and procedural data accuracy and completeness for final DRG assignment
• Review DRG denial letters and prepare denial appeal letters with supporting clinical evidence and regulatory guidelines
• Collaborate with care coordination, nursing, and ancillary staff to resolve physician clarifications prior to discharge
• Maintain compliance with all clinical documentation regulatory guidelines
• Prepare and submit timely appeals for reconsideration by third-party payors with appropriate clinical evidence and coding guidelines

What We're Looking For

• Current RN licensure (required)
• Minimum five years acute care nursing experience in medical/surgical, Intensive Care, or Emergency Department settings
• Excellent interpersonal, verbal, and written communication skills with strong physician relations capabilities
• Ability to organize and present information clearly and concisely
• Proficient computer and keyboarding skills with high-level prioritization abilities
• Inquisitive mindset with openness to innovation, including AI technologies, to improve processes and patient experiences
• Willingness and ability to travel to client, temporary, or corporate office locations as business needs require
• Must obtain HFMA Certified Revenue Cycle Representative (CRCR) certification within nine months of hire
• Must reside and be authorized to work within the United States

How We Work With You

Candidates apply directly through Get A Job.ai. Our talent team conducts an initial screening to understand your clinical background, CDI experience, and career goals. Qualified candidates are then presented to our client for consideration. Please do not attempt to contact the employer directly, as all communication is managed through our recruitment process.

This is a fully remote position with occasional travel requirements for client site visits or corporate meetings.

Pay

The client has indicated a base salary of $80,000 for this role, with bonus incentives available. Additional benefits include paid certifications, tuition reimbursement, and comprehensive health benefits.

Equal Opportunity

Get A Job.ai is committed to equal employment opportunity. We do not discriminate based on race, color, sex, sexual orientation, gender identity, religion, national origin, age, disability, veteran status, genetic information, or any other basis protected by applicable law.