Clinical Documentation Integrity Nurse

21 hours ago


Taguig, Philippines MicroSourcing Full time

Clinical Documentation Integrity Nurse - IP Location: TaguigWork setup & shift: Onsite | Night shift Why join MicroSourcing? Competitive Rewards: Above‑market compensation, healthcare coverage day one (you & at least one dependent), paid time‑off with cash conversion, group life insurance, performance bonuses. Collaborative Spirit: Contribute to a positive work environment through company‑sponsored events. Work‑Life Harmony: Flexible arrangements for balance. Career Growth: Continuous learning and advancement opportunities. Inclusive Teamwork: Diversity and inclusive culture. Your Role Conduct concurrent and retrospective reviews of inpatient medical records to ensure accurate and complete documentation reflecting diagnoses, treatment, and severity of illness. Identify documentation gaps or inconsistencies affecting coding, reimbursement, and quality metrics (SOI, 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, 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 2+ years inpatient CDI review experience 2+ years acute care clinical experience in hospital (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; proficiency with Microsoft Office Suite (Excel, Word, PowerPoint, Outlook, SharePoint) Strong analytical, critical thinking, and decision‑making skills Ability to work independently and handle complex decision‑making Excellent written and verbal communication skills Demonstrated teamwork, integrity, and professionalism 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. MicroSourcing firmly believes in an inclusive culture that embraces diversity. Our commitment to equality is a core value; we celebrate every individual's contribution. For more information, visit #J-18808-Ljbffr



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