📍 Location: [Insert Location]
💼 Job Type: Full-Time
💰 Salary: Competitive | Based on Experience | Benefits Package Available
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About the Role:
We are looking for an experienced Lead Denial Management and Clinical Documentation Integrity (CDI) Specialist to join our healthcare team. This role will involve overseeing the denial management process while ensuring the accuracy and completeness of clinical documentation to support appropriate reimbursement. The ideal candidate will have a strong background in CDI and denial management, with a focus on improving revenue cycle processes.
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Key Responsibilities:
- Lead denial management activities, including reviewing and analyzing denial trends, and implementing strategies to reduce denials
- Provide clinical documentation integrity (CDI) expertise to ensure accurate coding and reimbursement
- Collaborate with physicians, clinical staff, and coding teams to improve documentation practices
- Perform root cause analysis of denials and work closely with the payer relations team to resolve issues
- Ensure compliance with federal and state regulations related to healthcare documentation and reimbursement
- Train and mentor staff on denial management best practices and CDI guidelines
- Work with other healthcare teams to streamline workflows and ensure accurate and complete clinical documentation
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Qualifications:
- Bachelor’s degree in Nursing, Healthcare Administration, or a related field
- Certified Clinical Documentation Specialist (CCDS) or similar certification required
- Minimum of 5 years of experience in denial management and CDI, with at least 2 years in a leadership role
- Strong understanding of coding practices (ICD-10, CPT) and regulatory requirements (e.g., HIPAA, CMS)
- Proficient with Electronic Health Record (EHR) systems and denial management tools
- Excellent analytical, problem-solving, and communication skills
- Strong leadership abilities and experience training and mentoring teams
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What We Offer:
- Competitive salary based on experience
- Comprehensive benefits (medical, dental, vision, 401k, PTO)
- Career growth opportunities and ongoing professional development
- Collaborative and supportive work environment
- Remote work options available depending on the location
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How to Apply:
Please submit your resume and cover letter to [Insert Application Link or Email Address] with the subject line: “Lead Denial Management & CDI Specialist – [Your Name]”.