RN, Clinical Documentation Integrity Specialist Lead | Clinical Documentation Integrity (CDI)

RN Clinical Denial Recovery Analyst | Enterprise Denials

Turn clinical insight into revenue recovery—driving accurate appeals and reducing denials across the enterprise.

 Work Style: Remote
 Location Requirement: Must reside in an authorized state (FL, GA, PA, NC, SC, TN, or TX)
 FTE: Full-Time (1.0 FTE)

The Clinical Denial Management Nurse is responsible for completing, tracking, and reporting clinical denials across all UF hospitals at an enterprise level. Reporting to the Enterprise Denial Nurse Manager, this role supports key revenue cycle functions including clinical departments, finance, accounting, compliance, patient financial services, revenue integrity, managed care, utilization review, and patient access.

Serves as a clinical expert in denial management, reviewing denied claims from a clinical perspective and developing effective appeal strategies. Ensures appropriate documentation and submission of appeals to maximize reimbursement and minimize organizational write-offs.

Collaborates with cross-functional teams to identify denial trends, improve processes, and support enterprise-wide initiatives that enhance revenue cycle performance and compliance.

RN, Clinical Documentation Integrity Specialist, Lead – Key Responsibilities

• Lead initiatives to ensure the accuracy, completeness, and integrity of clinical documentation
• Review clinical records to identify documentation gaps and collaborate with providers to improve quality and compliance
• Develop and implement improvement strategies, education, and training programs for clinical staff
• Monitor regulatory changes and lead audits and quality assurance activities
• Serve as a liaison between clinical teams and coding specialists to ensure alignment and accuracy
• Analyze findings and report trends, recommending corrective actions to uphold documentation standards
• Promote best practices in clinical documentation to support patient care, compliance, and revenue integrity

Skills & Competencies

• Ability to work independently with minimal supervision
• Strong written and verbal communication skills
• Ability to generate clear, concise management reports, including audit results
• Ability to meet deadlines and adapt to frequent regulatory changes
• Strong ability to maintain positive relationships with internal and external stakeholders
• Self-starter with strong initiative and accountability

Minimum Qualifications

Education
Associate’s or Bachelor’s degree in Nursing required
Bachelor’s degree preferred
International Medical Graduate (IMG) with a Medical School Diploma may be considered in lieu of nursing degree

Licensure/Certification
Active RN license required (if applicable based on education pathway)
Certified Clinical Documentation Specialist (CCDS), Certified Documentation Integrity Practitioner (CDIP), or equivalent CDI certification preferred

Experience
• 5+ years of experience in Clinical Documentation Improvement (CDI), including leadership or lead-level responsibilities
• Strong expertise in regulatory compliance, audit management, and clinical documentation standards
• Proven ability to develop and implement training programs and process improvement initiatives
• Demonstrated success leading cross-functional teams and collaborating with clinical and coding professionals
• Experience monitoring documentation quality, analyzing trends, and reporting outcomes