Document Quality & Appeal Specialist

Remote, USA Full-time
Description: Could you be our next Documentation Quality and Appeals Specialist? Why work as a Documentation Quality and Appeals Specialist with Main Line Health? • *Remote Position** • Make an Impact! Are you an experienced CDI reviewer looking to join a premier healthcare provider? If so, come be a part of Main Line Health as a Documentation Quality and Appeals Specialist where you will use your extensive knowledge of clinical documentation requirements and ICD-10 guidelines to perform record review to ensure complete and accurate documentation for continuing care which reflects the appropriate Severity of Illness (SOI) and Risk of Mortality (ROM) as well as any potential Patient Safety Indicators (PSIs). Use your critical skills to understand legal and compliance issues and how they pertain to clinical documentation, and present information to clinical and end users. • Develop and Grow your Career! Invest in furthering your education through seeking certifications or advanced degrees by taking advantage of our Tuition Reimbursement! This position is eligible for up to $6,000 per year based upon your Full or Part Time status. • Get Involved! Get involved by attending educational coding sessions and maintaining clinical (RN) CEUs when applicable. • Join the Team! Like our patients, the Main Line Health Family encompasses a wide range of backgrounds and abilities. Just as each of our patients requires a personalized care plan, each of our employees, physicians, and volunteers, bring distinctive talents to Main Line Health. Regardless of our unique design, we all share a purpose: providing superior service and care. • Position-Specific Benefits include: You are eligible for up to 240 hours of paid time off per year based on your Full or Part Time status. We also offer a number of employee discounts to various activities, services, and vendors... And employee parking is always free! Position: Documentation Quality and Appeals Specialist Shift: Monday - Friday; day shift Experience: 1. Minimum one year experience as a CDI Reviewer in an acute care setting. 2. Minimum of five years of clinical experience in an acute care setting. 3. Working knowledge of DRGs and clinical conditions impacting quality outcomes is required. Education: 1. Bachelor’s Degree required. 2. Strong clinical training required. Licensures/Certifications: 1. CCDS or CDIP certification preferred. 2. CCS or concurrent enrollment in AHIMA-approved coding program within 90 days of hire. 3. RN is preferred. Apply tot his job
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