Clinical Documentation Improvement Coordinator (CDI) - ...

Short Description for Internal Candidates        Description for Internal Candidates    The Clinical Appeals Coordinator works in collaboration with the team of clinicians, coding professionals, physicians and HIM members to increase the team's program awareness, process and program benefits with the goal of decreasing denials, enhancing performance and increasing reimbursement for the health system. This person is a liaison for all government and commercial payer appeals. Coordinates the appeals process, job aides and workflows, participates in data gathering and analysis of reports regarding appeal activity as well as prepares for appeals audits, monitors QI (Quality Improvement) activities of appeals department, and assists in the development of department flows and implementations. Maintains all documentation associated with the processing and handling of appeals to comply with regulatory standards and timeframes.   Responsibilities for Internal Candidates    Coordinates daily operations of the Clinical Appeals Team office and provides support to Clinical Appeal Authors and Leadership. Performs a broad range of clerical/support/reception functions in the department and with other departments including CBO. Ensures that requests for information and services are accurately responded to, in a timely and appropriate manner.Reviews and triages denial reasons for justification of clinical appeal. Collaborates with other departments, vendors, and all other internal and external areas as necessary to secure responses for appeals and grievances. Enters all appeals in the software tracking system and tracks appeal resolution.Assists in analytical review of data to identify provider claims issues and provides feedback to management regarding trends. Identifies potential quality issues and escalates to the appropriate parties.Creates and maintains various departmental reports (CBO, ACM, Rubixis, RAC tracking and others as assigned/requested). Posts and distributes reports as required. Documents Policy and Procedures for department in a PDF or Master Document format.Effectively uses all applicable computer and office systems/procedures to coordinate documentation, data, and information for the shift to ensure timely communication and smooth operations. Ensures appropriate inventory of supplies and proper functioning of equipment. Ensures the work area is clean, clutter free, and organized.Schedules and coordinates events, training and conferences for the department. Keeps departmental calendar and files documents and prepares memo as necessary.   Qualifications for Internal Candidates    Southern Cali Hospital Culver CityRequired Qualifications: High School DiplomaTwo (2) years experience coordinating duties in clinical appeals and/or central billing office with a healthcare system.Two (2) years denials management experience working with government and commercial payersMust demonstrate customer service skills appropriate to the jobMust be able to read, write and communicate effectively in EnglishComputer literacy and proficiency including Microsoft office suiteAbility to multitask and prioritize needs to meet timelinesAbility to maintain flexibility and composure in a constantly changing environmentAbility to establish and maintain effective working relationships within the organizationAbility to work independently and with groups, identify potential issues and escalate appropriately Preferred Qualifications: Bachelors Degree Pay Rate: Min - $20.00 l Max - $26.00

Created: 2026-03-04