What are the responsibilities and job description for the CDI And Clinical Appeals Manager position at Managed Resources?
Company Description
Managed Resources, Inc., and its specialized division, CodingAID, are recognized leaders in revenue cycle management (RCM) and health information management (HIM). The organization provides consulting services and innovative solutions to health systems, academic medical centers, community hospitals, and physician groups nationwide. Key service offerings include Clinical Appeals and Denials Management, Clinical Documentation Improvement (CDI), Coding Compliance Audits, and RCM Consulting. With a focus on excellence, Managed Resources supports healthcare entities in improving financial performance and compliance.
Role Description
This is a full-time, on-site role for a CDI and Clinical Appeals Manager based in Auburn, WA. The position entails managing and overseeing clinical documentation improvement processes, leading clinical appeals to ensure successful denial resolutions, and implementing key compliance initiatives. Day-to-day responsibilities include auditing clinical records, collaborating with healthcare professionals, providing education and guidance on documentation practices, and maintaining up-to-date knowledge of regulatory requirements. Additionally, the role requires monitoring and analyzing data to identify trends and opportunities for process improvement.
Qualifications
- Strong expertise in Clinical Documentation Improvement (CDI) and Clinical Appeals processes
- Knowledge of auditing practices, Coding Guidelines, and Compliance regulations
- Ability to lead and mentor teams, with excellent communication and organizational skills
- Proficiency in healthcare data analysis, reporting, and identifying performance improvement areas
- Familiarity with healthcare coding practices, standards, and systems like ICD-10 and CPT codes
- Bachelor’s degree in a related field or equivalent professional experience
- CDIP (Certified Documentation Improvement Practitioner) or CCS (Certified Coding Specialist) certification is preferred
- Prior experience in healthcare revenue cycle management or hospital operations is an asset