Registered Nurse, Clinical Documentation Integrity Specialist

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

📋 Description

• Conduct clinical chart assessments to verify the accuracy of documentation by utilizing established clinical criteria.

• Assess how provider documentation, laboratory results, diagnostic data, and treatment plans are reflected in coded information.

• Analyze and interpret clinical data to uncover documentation gaps, inconsistencies, and areas for improvement.

• Engage with providers through a concurrent query process in accordance with ACDIS/AHIMA Guidelines for Compliant Query Writing.

• Liaise with providers and healthcare team members to clarify details or gather additional documentation.

• Collaborate with clinicians to enhance the quality and completeness of documentation via queries and provider training.

• Work alongside team members to ensure accurate and consistent clinical review outcomes.

• Achieve accuracy and productivity targets that align with departmental objectives.

• Report documentation challenges and trends to DaVita leadership.

• Attend scheduled departmental meetings.

• Facilitate individual and large-group training sessions for clinicians, medical coders, and other staff members.

• Collaborate with data analytics, coding, compliance, and education departments for onboarding and continuous education for IKC APPs and partner providers about Medicare risk-adjustment documentation requirements.

• Deliver in-person training as required while working remotely.

• Travel 2–4 times a year for on-site meetings.

• Assist leadership in achieving the strategic objectives of the department.

⛳️ Requirements

• An associate's degree with a current active clinical license (RN) is required.

• CCDS-O or CDIP certification is required or must be obtained within six months of hire.

• CRC certification is required or must be obtained within one year of hire.

• A minimum of 5 years of clinical experience as a Registered Nurse (adult-geriatric or family) is preferred.

• At least 3 years of experience in clinical documentation improvement, coding, or a related field is required.

• A minimum of 1 year of experience collaborating with advanced practice providers and other clinical and non-clinical staff is required.

• Strong clinical foundation in evidence-based medicine, including chronic disease management and prevention.

• Familiarity with ICD-10 coding, documentation standards, and risk adjustment.

• Understanding of compliant query writing/process.

• Capability to conduct thorough chart reviews of 20–30 medical records daily.

• Technical proficiency with EMR systems.

• Competency in MS Excel, Outlook, Teams, PowerPoint, and Word.

• Willingness to travel for on-site meetings 2–4 times per year.

• Advanced knowledge of Medicare risk adjustment, documentation, and coding standards.

• Over 2 years of experience offering risk adjustment education or management.

• More than 4 years of experience creating educational materials for clinical professionals.

• An associate's degree in nursing is mandatory.

• Comfortable delivering presentations via Teams or in person.

• Strong technical skills, particularly in Excel, Word, PowerPoint, and Outlook.

• Coding certification from AAPC or AHIMA, or equivalent coursework/experience in coding and risk adjustment, such as CPC, CRC, CCDS-O, or CDIP.

• Extensive experience with Medicare Advantage programs and the CMS Risk Adjustment model.

• Previous experience in clinical documentation review or a clinical quality program is essential.

• Expertise in developing and delivering clinical education and training.

• A current active RN clinical license is required.

🏝️ Benefits

• Medical, dental, and vision insurance coverage.

• 401(k) matching program.

• Paid time off (PTO).

• PTO cash-out option.

• Family support resources.

• EAP counseling services.

• Access to Headspace® for mental wellness.

• Backup childcare and eldercare services.

• Maternity and paternity leave.

• Professional development opportunities.

• On-demand virtual leadership and development courses available through DaVita’s StarLearning platform.

• Competitive total rewards package.

• Comprehensive healthcare coverage.