Clinical Documentation Improvement Nurse – Certified

🔥 0 minutes ago

🦞 Maine – Remote

🦞 Maine – Remote

💵 $86.9k - $107.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥📝 Medical Writer

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Martin's Point Health Care

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🛡️ Insurance

📦 Logistics

💼 Consulting

Insurance • Logistics • Consulting

Martin's Point Health Care is a healthcare organization committed to serving its local communities through high-quality primary and specialty care services. The organization places a strong emphasis on creating a positive workplace culture, recognizing employee contributions, and fostering workforce diversity. Martin's Point Health Care offers a range of career opportunities across various departments, from healthcare providers to corporate roles, and supports employee growth through competitive compensation, development programs, and generous perks. Additionally, the company is recognized for its community impact efforts, raising significant funds for community organizations and encouraging employee volunteerism.

📋 Description

• Partner with health plan, delivery system, and provider-network stakeholders to develop and implement clinical documentation and coding processes and best practices • Review clinical documentation to support HEDIS and participate in HEDIS medical record abstraction • Facilitate recommendations to improve clinical documentation and ensure coding reflects reviewed services • Confirm diagnosis-code accuracy on submissions to CMS • Educate providers and delivery-system and provider-network staff on quality and risk-adjustment documentation and reporting • Identify trends and execute action plans to improve documentation accuracy and capture risk-adjustment codes • Support accreditation and regulatory compliance and ensure HEDIS requirements and quality audits are met • Manage internal and external relationships supporting HEDIS and Risk Adjustment initiatives • Serve as a clinical risk-adjustment coding subject matter expert and help plan and execute coding efforts • Research CMS and regulatory publications and develop best-practice policies and provider educational materials • Review clinical records, identify gaps or inaccuracies, formulate clarifications, and communicate with providers regarding diagnoses, ICD-10 codes, and supporting documentation • Train providers, practice leadership, and designated staff on clinical documentation and risk-adjustment coding • Review and analyze population data and metrics to improve coding outcomes • Identify gaps between current and desired clinical operational structures • Develop monitoring tools to track CDI-program successes and challenges and facilitate process improvements • Perform other related duties as assigned

🎯 Requirements

• Bachelor’s Degree in Nursing required • Current RN license in good standing required • 5+ years’ clinical experience, preferably in geriatrics • 2 years of clinical coding experience preferred • One or more required certifications: CDI, CPC, CPC-H, CPC-P, CRC, CCS, CCS-P, or CPMA • Ability to speak and provide presentations and education to small and large groups • Ability to work a flexible schedule and willingness to travel locally as determined by business need • Knowledge of HEDIS and abstraction concepts preferred • Knowledge of Medicare Risk Adjustment preferred • Ability to assess population health needs and define health improvement priorities • Excellent verbal and written communication skills required • Self-motivated and accountable for project coordination and follow-through • Strong organizational and planning skills required • Ability to meet deadlines and produce accurate work • Ability to handle multiple tasks simultaneously • Ability to work independently • Strong clinical knowledge and understanding of Evidence-Based Practice principles • Ability to define and educate regarding appropriate sources for standards of care • Ability to review and analyze population data and metrics • Ability to create, build, and maintain relationships • Adaptability and flexibility in changing demands • Willingness to perform additional tasks as assigned • Must not require immigration sponsorship

🏖️ Benefits

• Medical insurance • Dental insurance • Vision insurance • Retirement savings with employer contributions • Paid time off • Volunteer time off • Pie day • Other employee benefits