Registered Nurse, Clinical Documentation Integrity Specialist

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

📋 Description

• Conduct clinical chart evaluations to verify the accuracy of documentation using set clinical criteria.

• Assess how provider documentation, lab results, diagnostic data, and treatment plans convert into coded information.

• Analyze and interpret clinical data to pinpoint documentation gaps, inconsistencies, and areas for enhancement.

• Engage with providers using a concurrent query process that aligns with ACDIS/AHIMA guidelines.

• Collaborate with providers and healthcare team members to clarify details and acquire further documentation.

• Partner with clinicians to enhance the quality and completeness of documentation through queries and provider education.

• Address disease processes, severity, complexity, and acuity to ensure accurate medical coding.

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

• Achieve accuracy and productivity targets.

• Report documentation issues and trends to DaVita leadership.

• Take part in scheduled departmental meetings.

• Facilitate both individual and large-group educational sessions for clinicians, medical coders, and other relevant staff.

• Collaborate with data analytics, coding, compliance, and education teams for onboarding and ongoing focused education.

• Instruct IKC APPs and partner providers on Medicare risk-adjustment documentation standards.

• Assist the clinical documentation integrity leadership team in fulfilling strategic objectives.

• Travel 2–4 times per year as necessary for in-person training presentations.

⛳️ Requirements

• An Associate's degree in nursing is required.

• A current active clinical license (RN) is mandatory.

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

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

• Preferred: 5+ years of clinical experience as a Registered Nurse.

• Required: 3+ years of clinical documentation improvement, coding experience, or equivalent.

• Required: 1+ year of experience collaborating with advanced practice providers and other clinical and non-clinical personnel.

• Solid 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 and processes.

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

• Technical proficiency in EMR systems.

• Proficient in Excel, Outlook, Teams, PowerPoint, and Word.

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

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

• Minimum of 2+ years of experience in risk adjustment education or management.

• At least 4+ years of experience in creating educational content for clinical professionals.

• Comfortable presenting via Teams or in-person settings.

• Strong technical skills encompassing Excel, Word, PowerPoint, and Outlook.

• Coding certification from AAPC or AHIMA, or related coursework/experience in coding and risk adjustment.

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

• Previous involvement in clinical documentation review or clinical quality initiatives.

• Experience in developing and delivering clinical education and training programs.

• Exceptional analytical and critical thinking abilities.

• Excellent verbal, written communication, and interpersonal skills.

• Ability to work autonomously and collaboratively within a fast-paced environment.

• Self-motivated and a creative problem-solver.

🏝️ Benefits

• Comprehensive medical, dental, and vision insurance.

• 401(k) matching contributions.

• Paid time off.

• PTO cash-out options.

• Family support resources.

• EAP counseling services.

• Access to Headspace.

• Backup child and elder care services.

• Maternity and paternity leave.

• Opportunities for professional development.

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

• Competitive total rewards package.