HCC Clinical Documentation Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Act as a subject matter expert in the quality of clinical documentation, risk adjustment, and the integrity of HCC coding within outpatient environments.

• Conduct prospective reviews of medical records from physician practices, outpatient facilities, and pertinent inpatient encounters.

• Verify chronic conditions while ensuring accuracy in documentation, clinical integrity, proper coding, and effective HCC capture.

• Utilize Epic and OurPractice Advisories (OPAs) to execute prospective chart reviews and pinpoint documentation enhancement opportunities.

• Facilitate precise coding, HCC capture, and initiatives aimed at maintaining clinical documentation integrity.

• Oversee and manage work queues, review inventories, and activities related to OPAs.

• Guarantee timely follow-ups, meet productivity goals, and ensure the accurate completion of CDI interventions.

• Track, analyze, and report on CDI outcomes, documentation trends, and performance related to HCC recapture.

• Recognize areas for improvement and support the objectives of the program.

⛳️ Requirements

• At least 2 years of experience in ambulatory Clinical Documentation Integrity, Risk Adjustment, or similar healthcare documentation roles.

• A valid LPN or RN license is mandatory.

• CCDS, CCDS-O, CDIP, CDEO, and/or CRC certification is highly preferred.

• Familiarity with Epic workflows, including the interpretation and management of OurPractice Advisories (OPAs) is preferred.

• Strong comprehension of ICD-10-CM coding guidelines and requirements for HCC documentation and coding.

• Robust understanding of clinical criteria for HCC diagnoses.

• Exceptional communication, critical thinking, and organizational abilities.

• Proficient in using MS Office, email, VPNs, virtual machines, two-factor authentication, and video conferencing tools such as MS Teams and Zoom.

🏝️ Benefits

• Comprehensive benefits package.

• Paid Time Off (PTO).

• Competitive compensation.

• A collaborative, mission-driven team atmosphere.

• Opportunities for ongoing learning, education, and professional development.

• Leadership that appreciates your expertise and contributions.