[Hiring] Clinical Documentation Specialist @Reveleer

Role Description

The clinical documentation specialist (Outpatient) is responsible for facilitating improvement in the overall quality and completeness of Clinical Intelligence's recapture and suspecting performance. The specialist will perform reviews of patient records to identify and validate Hierarchical Condition Category (HCC) diagnoses. The specialist will query providers to ensure accurate and complete documentation that supports HCC and condition-related diagnoses, ultimately enhancing RAF score accuracy and improving risk adjustment outcomes.

• Apply comprehensive knowledge of medical terminology, disease processes, treatment modalities, diagnostic tests, medications, and procedures to identify gaps in the overall quality and completeness of clinical documentation.
• Validate recapture and suspect conditions based on clinical evidence.
• Validate documentation supports reported conditions.
• Create queries reflective of best practice.
• Formulate recommendations to improve clinical logic and workflows.
• Maintain strict confidentiality of patient information in accordance with privacy regulations.

Qualifications

• Strong understanding of CMS, HHS, Medicaid, and Rx HCC models.
• Up to date with industry standards related to HCC documentation, ICD-10-CM coding, AHA Coding Clinics, and Official Coding Guidelines.
• Proficient in the use of electronic medical records and technology enabling solutions.

Requirements

• Graduate of an accredited nursing education program.
• Active and unrestricted Registered Nurse or Advanced Practice Provider license.
• Certified Documentation Expert-Outpatient (CDEO) or Certified Clinical Documentation Specialist- Outpatient (CCDS-O) or Certified Documentation Improvement Practitioner (CDIP) and Certified Risk Adjustment Coder (CRC).
• Minimum of 2 years outpatient CDI experience.
• Experience navigating Epic, Athena, and Cerner EMRs.
• 5 years of clinical experience.

Benefits

• Competitive salary.
• Medical, Dental and Vision benefits.
• 401k match.
• Generous PTO plan.