New Jersey Licensed Clinical Documentation Specialist

Job Summary

A company is looking for a Clinical Documentation Integrity DRG Downgrade Specialist.

Key Responsibilities

• Analyze payer DRG downgrade notifications and conduct comprehensive medical record reviews
• Write persuasive appeal letters and track cases through the appeal lifecycle
• Collaborate with internal teams to improve documentation practices and participate in audits

Required Qualifications

• Bachelor's degree in Nursing required
• Minimum of 3 years of experience in a clinical documentation improvement role
• RN, CCDS and/or CDIP with CCS certification required
• Demonstrated inpatient coding experience in an acute care setting
• Deep knowledge of ICD-10-CM/PCS and DRG reimbursement systems