Clinical Documentation Integrity Specialist, Bilingual in Spanish/English

🔥 2 hours ago

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Duo Health

WebsiteLinkedInAll Job Openings

11 - 50 employees

🏥 Healthcare

🤝 B2B

👥 B2C

Healthcare • B2B • B2C

Duo Health is a medical group focused on improving care for people with chronic kidney disease and kidney failure. It partners with nephrologists, health systems, and insurers to identify patients earlier, provide holistic, patient-centered care (including in-home care), and support transitions to value-based care. Duo emphasizes collaboration with existing doctors, health equity, and improving outcomes and experience for patients while empowering nephrology practices.

📋 Description

• Review clinical documentation to ensure accurate, complete, and compliant coding in accordance with ICD-10-CM, HCC, and regulatory guidelines • Serve as the subject matter expert on outpatient risk adjustment documentation and HCC coding requirements • Conduct Clinical Documentation Integrity (CDI) reviews and Quality reviews to ensure accurate capture of quality measures and risk adjustment data • Query providers for documentation clarification while maintaining compliance with coding and documentation standards • Analyze documentation trends and identify opportunities for provider education, workflow improvements, and operational optimization • Develop and deliver ongoing education and training to providers on documentation best practices and coding requirements • Build strong collaborative relationships with providers and cross-functional teams across the organization • Assist leadership with analysis, trending, reporting, and presentation of audit findings and documentation improvement opportunities • Review and interpret Spanish-language medical records to ensure accurate ICD-10 and CPT coding • Communicate effectively in both Spanish and English with providers and care team members regarding documentation questions and coding guidance • Identify documentation trends within Spanish-language records and communicate findings to stakeholders to improve coding accuracy and risk capture • Support bilingual care teams by translating or clarifying documentation-related concepts while maintaining compliance standards • Provide documentation guidance to Spanish-speaking frontline Care Navigators as needed • Assist with translating documentation education and training materials for Spanish-speaking providers and care teams • Maintain confidentiality of patient information and adhere to all company policies and compliance requirements • Support Duo Health's continuous quality improvement initiatives

🎯 Requirements

• Minimum of 5 years of Clinical Documentation Integrity (CDI) and Quality experience • Minimum of 3 years of outpatient risk adjustment CDI experience • Fluency in both spoken and written Spanish and English is required • Ability to read, interpret, and analyze clinical documentation written in Spanish • Ability to communicate effectively with clinicians and internal teams in both English and Spanish • Strong knowledge of ICD-10-CM coding, HCC risk adjustment methodology, medical terminology, disease processes, pharmacology, and clinical documentation standards • Experience independently managing projects and driving documentation improvement initiatives • Bachelor's degree in nursing preferred; equivalent education and experience will be considered • CCS, CRC, CPC, CCDS, or CDIP certification preferred • Strong analytical, organizational, and critical thinking skills with exceptional attention to detail • Comfortable working independently in a fast-paced, remote environment • Excellent written and verbal communication skills • Ability to build strong working relationships and collaborate effectively in a virtual environment

🏖️ Benefits

• Competitive medical, dental, and vision plans • Paid maternity and paternity leave • Adoption Assistance • Access to free wellness & personal development courses • 401(k) plan with company matching • 12 Paid holidays