Job Description

DRG/CDI Nurse (Clinical Documentation Improvement)

📍 Location: Fully Remote | 🕒 Full-Time | 🏥 Healthcare

About the Role

We’re seeking a highly skilled DRG/CDI Nurse to join our team and play a critical role in improving clinical documentation accuracy. This position ensures that patient records reflect the true severity of illness, risk of mortality, and complexity of care—supporting appropriate DRG assignment, quality reporting, and reimbursement.

Key Responsibilities

• Concurrent Chart Review : Analyze patient records to ensure diagnoses are specific, complete, and clinically supported.
• Physician Queries : Collaborate with providers to clarify documentation and obtain specificity for accurate DRG assignment.
• Audit & Denials Management : Review high-dollar and Medicare claims; manage DRG denials and construct evidence-based appeal letters.
• Documentation Improvement : Identify gaps and educate care teams on best practices for clinical documentation.
• Compliance Monitoring : Stay current with coding standards, AHIMA guidelines, and prospective payment systems.

Qualifications

• Licensure : Active RN license required.
• Experience : Minimum 5 years of acute care clinical experience.
• Knowledge : Strong understanding of medical terminology, disease processes, and ICD-10-CM coding.
• Certifications :
  • CCDS (Certified Clinical Documentation Specialist) – preferred or required within a set timeframe.
  • CDIP (Certified Documentation Improvement Professional) – also accepted.
• Skills :
  • Excellent verbal and written communication.
  • Strong analytical thinking and attention to detail.

Who We Are

Headquartered in Central Florida, Pivotal Placement Services is a full-service national workforce solutions firm that specializes in placing healthcare professionals—from staff to leadership—with both clinical and non-clinical employers. Our comprehensive and customer-focused workforce solutions include Direct Placement and Managed Service Provider (MSP) / Vendor Managed Services (VMS) engagements nationwide.

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