[Hiring] Clinical Documentation Integrity Specialist @UnitedHealth Group

Role Description

Optum Insight is improving the flow of health data and information to create a more connected system. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

• Provides expert level review of inpatient clinical records within 24-48 hours of admit; identifies gaps in clinical documentation that need clarification for accurate code assignment to ensure the documentation accurately reflects the severity of the condition and acuity of care provided.
• Conducts daily follow-up communication with providers regarding existing clarifications to obtain needed documentation specificity.
• Provides expert level leadership for overall improvement in clinical documentation by providing proficient level review and assessment, and effectively articulating recommendations for improvement, and the rationale for the recommendations.
• Actively communicates with providers at all levels, to clarify information and to communicate documentation requirements for appropriate diagnoses based on severity of illness and risk of mortality.
• Provides timely feedback to providers regarding clinical documentation opportunities for improvement and successes.
• Ensures effective utilization of CDI software to document all verbal, written, electronic clarification activity.
• Proactively develops a reciprocal relationship with the HIM Coding Professionals.
• Engages and consults with Physician Advisor/VPMA when needed, per the escalation process, to resolve provider issues regarding answering clarifications and participation in the clinical documentation improvement process.

Qualifications

• Must be one of the following to qualify:
• A Medical Graduate (MD or MBBS)
• Registered Nurse (RN) with an active, unrestricted RN License in the US and 5+ years of acute care hospital experience
• Current CCDS, CDIP, or CCS Certification OR willing/able to obtain within 1 year of hire
• 2+ years of experience working as a Clinical Documentation Improvement Specialist in an acute care hospital setting
• Advanced level of proficiency in clinical medicine, pathophysiology, and pharmacology
• Intermediate level of proficiency using a PC in a Windows environment, including Microsoft Word, Excel, PowerPoint, and Electronic Medical Records
• Must be able to work Pacific Time Zone business hours (Monday – Friday) regardless of remote work base location/residency

Preferred Qualifications

• BSN degree if a RN
• 3+ years of experience working in an acute care hospital
• CAC experience (Computer Assistant Coding)

Soft Skills

• Experience communicating & working closely with Physicians

Requirements

• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Benefits

• Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc.
• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)
• Salary for this role will range from $60,200 - $107,400 annually based on full-time employment

Application Deadline

• This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected.
• Job posting may come down early due to volume of applicants.