Senior Clinical Documentation Integrity Specialist

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🕒 June 1

⚜️ Louisiana – Remote

⚜️ Louisiana – Remote

⏰ Full Time

🟠 Senior

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Blue Cross and Blue Shield of Louisiana

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1934

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross Blue Shield Association, offering a range of health insurance products and services in the state of Louisiana. The company provides health, dental, and travel insurance options, including Medicare Advantage plans such as HMO and PPO. They focus on delivering comprehensive healthcare coverage through various plans to meet varying customer needs, while partnering with doctors, hospitals, and clinics to ensure quality care and support. Additionally, the company emphasizes wellness programs, cost-saving opportunities, and accessibility for its members.

📋 Description

• Ensures accurate, complete, and compliant clinical documentation that appropriately reflects severity of illness, risk of mortality, and supports correct reimbursement • Partners closely with providers, coding teams, and practice participants to drive documentation quality, regulatory compliance, and value-based care initiatives • Develops and implements standard processes, job aids, and error prevention tools to strengthen clinical documentation integrity across participating practices • Educates providers and office staff on best-practice clinical documentation standards to ensure accuracy, completeness, and compliance • Conducts prospective and retrospective reviews and prepares analyses and reports to identify trends, gaps, and improvement opportunities • Provides guidance and consultation to internal practice staff to improve coding proficiency and documentation accuracy • Collaborates with population health and practice teams to support quality programs, value-based initiatives, and standardized data abstraction processes • Advises practice staff on compliance with applicable federal, state, and local regulations related to Medicare coding and documentation guidelines

🎯 Requirements

• Bachelor’s degree in a related field (4 years of related experience can be used in lieu of degree) • Minimum of 5 years of experience in Clinical Documentation Integrity (CDI) or coding • At least 3 years of experience supporting healthcare value-based programs, including Medicare Risk (experience may run concurrently) • At least one required certification, such as CPC, CRC, CCS‑P, CCS‑H, RHIT, CCDS, or CDIP • Advanced knowledge of ICD‑10 coding guidelines and clinical documentation standards • Strong understanding of CMS quality programs, HCCs, value‑based care models, and EHR systems • Excellent written, verbal, interpersonal, and presentation skills • Advanced proficiency in Microsoft Office applications (Excel, Word, PowerPoint, Outlook) • Strong critical thinking, problem‑solving, and time‑management skills

🏖️ Benefits

• health insurance • 401(k) matching • flexible working hours • paid time off • professional development opportunities