Lead CDI Specialist Second Level Reviewer

Overview

At Garnet Health, the Hudson Valley’s leading integrated health system, you’ll find the perfect balance of a satisfying career and a rewarding lifestyle. Our focus is on patient-centric care with a collective of visionary leaders and dedicated and caring professionals working as a team to deliver the best for the people we serve. If you’re interested in a health system that’s both growing and award-winning, serving a diverse community that provides the best of both city and rural life, we invite to make your career home with us as a Lead Clinical Documentation Specialist 2nd Level Reviewer on our Clinical Documentation Intergrity team at/in Garnet Health Medical Center-Middletown.

Responsibilities

The Lead CDI Specialist – Second Level Reviewer is responsible for performing advanced secondary reviews of complex clinical documentation, coding opportunities, and provider queries to ensure accuracy, compliance, clinical integrity, and appropriate reimbursement. This role serves to support accurate capture of severity of illness, risk of mortality, and other quality and reimbursement indicators. The Lead CDI second level reviewer also provides advanced oversight of the organization’s AI-assisted CDI software, including evaluation of AI-generated logic, recommendations, acceptance and rejection patterns, and overall accuracy against organizational, AHIMA, and ACDIS guidelines. The role identifies trends, opportunities, and areas of risk and provides findings and recommendations to support ongoing improvement of CDI, coding, and AI-assisted workflows .

At Garnet Health, we are committed to supporting your career growth and professional potential. We are responsive, attentive and dedicated to the success and satisfaction of our team members. Here, you’ll find resources that will help you excel in your career, tuition reimbursement programs for your continued education, and comprehensive health, dental and retirement benefits designed to fit your individual and family needs. Our inclusive and diverse team culture encourages you to contribute your exceptional talents, skills and perspectives to the success of our system, one another, our communities and our patients.

Join the Garnet Health team and let your excellence shine.

Salaries shown on independent jobs related websites reflect market averages and do not represent information obtained directly from Garnet Health System. We invite and encourage each candidate to discuss salary / hourly specifics during the application and hiring process.

Compensation for the role is $48.8534- $57.9004/hr .

Fully remote from the following states: Pennsylvania; Florida; South Carolina; North Carolina; Texas

Garnet Health System provides a compensation range to comply with the New York State law on Salary Transparency in Job Advertisements. The range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits. When determining a team member’s compensation and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity)

Qualifications

Minimum Education:

• Bachelor's Degree in Nursing

Minimum Experience:

• Five (5) years of progressive acute care clinical experience and three (3) years of CDI experience required.

• Strong knowledge of ICD-10-CM/PCS coding guidelines, DRG methodologies, and inpatient reimbursement.

• Experience performing CDI audits, quality reviews, and second-level reviews required.

• Knowledge of DRG validation, clinical validation, coding denials, and appeal processes.

• Advanced knowledge of inpatient CDI practices and compliant query guidelines.

• Strong analytical, auditing, critical-thinking, and problem-solving skills with the ability to independently evaluate complex clinical and coding scenarios.

• Excellent written and verbal communication skills with the ability to clearly communicate findings and recommendations to clinical and non-clinical stakeholders.

• Proficiency with electronic medical records, CDI software, and Microsoft Office applications.

• Ability to work independently, manage multiple priorities, and meet deadlines in a remote environment.

• Strong organizational and interpersonal skills with the ability to build effective collaborative relationships.

• Required Certification/Registration:

• Required: Current NYS RN license; Certified Clinical Documentation Specialist (CCDS).

• Preferred: Certified Coding Specialist (CCS).

Working Conditions:

• Environmental Demands and Exposure to Hazards: Works in a clean, lighted, heated or ventilated facility. No routine exposure to hazards.

• Physical Demands: Demonstrates physical and functional ability to perform full anatomical range of motion to accomplish tasks. Evidence of visual and aural acuity and finger and hand dexterity to operate computer and office equipment. Can withstand long periods of sitting, standing and/or constant walking. Ability to lift 10 lbs.

• Mental Demands: Ability to foster collaborative relationships, to work well under pressure, to organize and synthesize new information, and prioritize tasks. Possesses critical thinking, analytical skills and flexibility. Ability to multi-task. Required detailed attention to work in an environment where interruptions cannot be controlled. Demonstrates sensitivity to customer needs and expectations. May be subject to irregular hours including evenings or potentially weekends to participate in operational and community events as necessary.