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 areas of clinical documentation quality, risk adjustment, and HCC coding integrity within the outpatient environment.

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

• Validate chronic conditions while ensuring accuracy in documentation, clinical integrity, appropriate coding, and HCC capture.

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

• Assist in maintaining accurate coding, HCC capture, and initiatives that promote clinical documentation integrity.

• Oversee and manage work queues, inventory reviews, and OPA-related tasks.

• Ensure timely follow-up, meet productivity goals, and accurately complete CDI interventions.

• Monitor, analyze, and report on CDI outcomes, documentation trends, and HCC recapture performance.

• Identify areas for improvement and contribute to the achievement of program objectives.

⛳️ Requirements

• At least 2 years of experience in ambulatory Clinical Documentation Integrity, Risk Adjustment, or a related field in healthcare documentation.

• A current LPN or RN license is required.

• 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 knowledge of ICD-10-CM coding guidelines along with HCC documentation and coding standards.

• Good understanding of clinical criteria relevant to HCC diagnoses.

• Excellent communication, critical thinking, and organizational abilities.

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

🏝️ Benefits

• Comprehensive benefits package.

• Paid Time Off (PTO).

• Competitive compensation.

• Supportive, mission-driven team atmosphere.

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

• Leadership that appreciates your expertise and contributions.