Clinical Documentation Integrity Specialist, Bilingual in Spanish/English

🕒 il y a 11 jours

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Duo Health

Site WebLinkedInTous les Emplois

11 - 50 employés

🏥 Santé

🤝 B2B

👥 B2C

Healthcare • B2B • B2C

Duo Health est un groupe médical dédié à l'amélioration des soins pour les personnes atteintes de maladie rénale chronique et d'insuffisance rénale. Il collabore avec des néphrologues, des systèmes de santé et des assureurs pour identifier les patients plus tôt, offrir des soins holistiques centrés sur le patient (y compris des soins à domicile), et soutenir la transition vers des soins basés sur la valeur. Duo met l'accent sur la collaboration avec les médecins existants, l'équité en santé, et l'amélioration des résultats et de l'expérience des patients tout en autonomisant les pratiques de néphrologie.

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

🎯 Exigences

• 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

🏖️ Avantages

• 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