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Clinical Documentation Manager

Clinical Documentation Manager

HealthSearch GroupOrange County, NY, US
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Job Description

Job Title : Manager, Clinical Documentation Integrity (CDI) & DRG Denials

Are you passionate about driving excellence in clinical documentation and leading high-performing teams? We are seeking a Manager of Clinical Documentation Integrity (CDI) & DRG Denials to lead our CDI department and oversee the DRG denials appeals process within a growing, award-winning health system serving a diverse community in the beautiful Hudson Valley.

This is an opportunity to join a patient-centered, forward-thinking organization where collaboration, innovation, and quality care are at the core of everything we do.

Key Responsibilities

  • Lead the day-to-day operations of the CDI department and DRG denials process.
  • Develop, implement, and evaluate policies and procedures related to clinical documentation improvement across multiple hospital sites.
  • Ensure medical record reviews are conducted to assess appropriateness and medical necessity for admission and continued stay.
  • Facilitate improvement in the quality, completeness, and accuracy of medical record documentation.
  • Collaborate closely with outcomes managers and coding denial coordinators to review and write compelling appeals for third-party denials.

Qualifications

✅ Education :

  • Bachelor’s Degree in Nursing (required).
  • ✅ Experience :

  • Minimum 5 years of progressive experience in an acute care hospital (100+ beds).
  • Minimum 5 years of experience in the CDI industry.
  • Strong knowledge of ICD-10 diagnosis coding, CPT coding guidelines, DRG-based reimbursement, and DRG / coding appeal process.
  • Exceptional communication skills with physicians and clinical staff.
  • ✅ Licenses / Certifications :

  • Current NY State RN license (required).
  • Certified Clinical Documentation Specialist (CCDS) credential (required).
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