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R1 RCM

Technology-driven revenue cycle management for providers

RN Nurse Clinical Documentation Improvement Specialist

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours
Full-timeRemote

About the Job

Requirements

  • An Associate’s Degree in Nursing is required; a Bachelor’s Degree in Nursing is preferred.
  • An active US RN license is required.
  • Front-line CDI experience in an acute care hospital is required.
  • Three to five years of recent clinical work experience in the medical-surgical area, ICU, telemetry, and/or emergency department is required.
  • Knowledge or experience with electronic medical record platforms and CDI platforms is required.
  • Knowledge of CDI practices, coding, and documentation requirements related to quality outcomes and reimbursement is required.
  • Experience evaluating medical record data for accuracy and reimbursement, and staying current on CMS rules and regulations, is required.
  • An active RN license with experience in ICU, medical-surgical, telemetry, or emergency department settings is required.

Responsibilities

  • Conduct clinically based concurrent and retrospective reviews of inpatient medical records.
  • Evaluate clinical service documentation to identify opportunities to improve medical record documentation, including focused mortality reviews, PSI reviews, and other designated projects.
  • Facilitate and obtain appropriate physician documentation for clinical conditions or procedures to support severity of illness, expected risk of mortality, and complexity of patient care.
  • Participate in ongoing documentation improvement initiatives, including formal and informal education plans for providers and the CDI team.
  • Initiate physician interaction when the medical record contains ambiguous, missing, or conflicting information by using the physician query process and/or participating in physician rounds to request documentation supporting correct coding, compliance, and accurate reflection of case mix index, length of stay, and resource utilization.
  • Educate physicians and other staff on documentation requirements, coding guidelines, and reimbursement policies.
  • Use hospital coding code sets, policies and procedures, federal and state coding reimbursement guidelines, and Coding Clinic Guidelines to assign working diagnosis-related groups and review identified patient records throughout hospitalization to ensure codes are reported at the highest specificity.
  • Collaborate with coders, auditors, quality improvement teams, and other stakeholders to resolve documentation issues and improve coding accuracy.
  • Stay current on developments and changes in clinical documentation standards, coding rules, and regulatory requirements.
  • Conduct focused reviews identified by CDI leadership, including mortality reviews, PSI reviews, and other projects.

Desired Qualifications

  • A Bachelor’s Degree in Nursing is preferred.

About the Company

R1 RCM

Technology-driven revenue cycle management for providers

R1 RCM provides revenue cycle management solutions for healthcare providers, helping hospitals, health systems, and physician groups manage patient service revenue. Its products cover front-end, middle, and back-end processes—from registration and scheduling to coding, billing, collections, and denials management—using automation to streamline workflows. The company differentiates itself by offering end-to-end RCM services under long-term contracts with performance-based incentives, acting as a single vendor for multiple revenue-cycle needs and leveraging data-driven insights. Its goal is to cut administrative waste, improve financial performance, and enhance the patient experience so providers can focus more on patient care.

Company size
10,001+
Company stage
IPO
Headquarters
Murray, UT
Founded
2003

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