Clinical Documentation Improvement Nurse Specialist

Discover your 100% YOU with MicroSourcing Position: Clinical Documentation Improvement Nurse Specialist - IP Location: Taguig Work setup & shift: Onsite | Night shift Why join MicroSourcing? You'll have: Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one (for you and at least one dependent), paid time‑off with cash conversion, group life insurance, and performance bonuses. A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities. Work‑Life Harmony: Enjoy balance between work and life with flexible arrangements that suit you. Career Growth: Take advantage of opportunities for continuous learning and career advancement. Inclusive Teamwork: Be part of a team that celebrates diversity and fosters an inclusive culture. Your Role: Conduct concurrent and retrospective reviews of inpatient medical records to ensure accurate and complete documentation that reflects the patient's diagnoses, treatment, and severity of illness. Identify documentation gaps or inconsistencies affecting coding, reimbursement, and quality metrics such as Severity of Illness (SOI) and Risk of Mortality (ROM). Issue compliant physician queries following AHIMA/ACDIS standards and ensure timely follow‑ups and closures. Monitor and maintain 100% query compliance through daily tracking, escalation of non‑responses, and physician education as needed. Collaborate with coding and documentation teams to ensure accurate MS‑DRG and APR‑DRG assignment and proper application of ICD‑10‑CM/PCS coding guidelines. Provide data‑driven feedback and recommendations on documentation trends and process improvements. Support denial prevention initiatives by ensuring clinical validity and medical necessity in documentation. Partner with the Clinical Denials & Appeals team to resolve payer denials and reduce avoidable denials. Track daily CDI activities including cases reviewed, queries sent, physician response rates, and DRG impacts, and generate weekly and monthly reports for leadership. Ensure compliance with AHIMA and ACDIS guidelines, and participate in continuous improvement initiatives, policy development, and professional development activities. What You Need: Non‑negotiables Bachelor of Science in Nursing Active PHRN or USRN license At least 2 years of inpatient CDI review experience Minimum of 2 years of acute care clinical experience in a hospital setting (ICU or Med/Surg preferred) Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), or Certified Coding Specialist (CCS) Working knowledge of ICD‑10‑CM/PCS coding, MS‑DRG methodology, and risk adjustment Experience with EMR systems such as Epic, Cerner, or Meditech Preferred skills/expertise Master's degree or credential in business, healthcare, or related field Experience with CDI or coding technologies and proficiency with Microsoft Office Suite (Excel, Word, PowerPoint, Outlook, SharePoint) Strong analytical, critical thinking, and decision‑making skills Proven ability to work independently and handle complex decision‑making Excellent written and verbal communication skills Demonstrated teamwork, integrity, and professionalism in all interactions Experience in a matrixed environment About MicroSourcing With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines. Our commitment to 100% YOU MicroSourcing firmly believes that our company's strength lies in our people's diversity and talent. We are proud to foster an inclusive culture that embraces individuals of all races, genders, ethnicities, abilities, and backgrounds. We provide space for everyone—embracing different perspectives and making room for opportunities for each individual to thrive. At MicroSourcing, equality is not merely a slogan - it's our commitment. Our way of life. Here, we don't just accept your unique, authentic self — we celebrate it, valuing every individual's contribution to our collective success and growth. Join us in celebrating YOU and your 100% For more information, visit Terms & conditions apply. #J-18808-Ljbffr