What are the responsibilities and job description for the Clinical Documentation & Denials Specialist position at Graham Health System?
Clinical Documentation & Denials Specialist
It is the mission of Graham Health System to provide compassionate, quality health services, in a responsible and charitable manner, to the people and communities we serve. We are the community’s choice for an exceptional healthcare experience. Graham Health System is seeking a great applicant to join our team. Graham Health System offers a great team atmosphere with multiple benefits. Our goal is to provide the very best in healthcare, state-of-the-art equipment, modern facilities, and a caring, compassionate staff, all close to home. We offer a great team atmosphere with a competitive wage and benefit package for our dedicated employees. Opportunely, we are always in search of great applicants to join our team.
The Clinical Documentation & Denials Specialist ensures clinical medical records accurately reflect patient care to support precise medical coding and compliant reimbursement. This role focuses on reviewing clinical documentation, applying official coding guidelines, and analyzing complex claim denials to draft clinical appeals and prevent recurring revenue leaks. This position will report to the Health Information and Denials Management Director.
Position Qualifications
- Associate degree in Health Information Management (HIM); or equivalent work experience
- Active certification from AHIMA (such as CCS, RHIA, RHIT) or AAPC (such as CPC, CIC, COC)
- Dedicated CDI or denial credentials such as CDIP, CCDS, or CDEO are highly preferred
- Minimum of 2-3 years of experience in inpatient/outpatient medical coding, clinical documentation improvement, or healthcare denials management in a facility setting.
- Understanding of MS-DRG. Strong knowledge of Emergency Room Evaluation, Infusion and injection, Observation hour calculation and Anesthesia codes; deep expertise in national coding guidelines, medical terminology, anatomy, and Electronic Health Record (EHR) systems
- Working knowledge of Microsoft Word, Excel, Teams
- Strong critical thinking skills to interpret insurance medical policies and write persuasive, evidence-based appeal letters.
We strongly encourage you to include an updated resume when submitting your application.
Benefits of working at GHS:
- Cost of Living Adjustment every July
- Financial Assistance and Loan Forgiveness may be available
- Daycare Assistance
The pay grade assigned to this position is 2700; the link provided shows the pay range. Compensation Information All wages are determined by experience and skills; wage information will be discussed further upon interview selection.
The position status type is full-time. Benefits associated with the employment status can be found in the link provided. Benefit Package