Clinical Documentation Improvement Specialist

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🔥 1 minute ago

🇺🇸 United States – Remote

💵 $70k - $85k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥📝 Medical Writer

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Health Choice Network

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 1994

🏥 Healthcare

🤝 Non-profit

☁️ SaaS

Healthcare • Non-profit • SaaS

Health Choice Network is a Miami-based organization that operates as a network supporting community health centers and safety-net primary care providers. It provides technology, data and operational support to help clinics coordinate care, manage population health, and meet value-based care and reporting requirements, while also engaging in advocacy and workforce/employee initiatives. The organization lists a Miami address (9064 N. W. 13 Terrace) and the domain hcnetwork. org.

📋 Description

• Serve as a subject matter expert on ICD-10-CM Coding Guidelines, AHA Coding Clinic guidance, and Risk Adjustment methodologies • Conduct proactive medical record reviews to evaluate documentation quality, diagnosis coding accuracy, co-morbidities, complications, and appropriate secondary diagnoses • Ensure patient conditions are accurately documented and coded to support quality care and appropriate risk stratification • Identify documentation and coding trends impacting patient risk scores and value-based care performance • Develop and deliver education programs for providers, coders, and clinical care teams • Provide guidance on documentation best practices, coding updates, compliance requirements, and risk adjustment principles • Create educational tools, resources, and training materials • Partner with providers to identify documentation improvement and workflow optimization opportunities • Collaborate with contracted health plans on risk adjustment and value-based care initiatives • Support auditing activities, review health plan findings, and develop performance improvement plans when needed • Participate in clinical quality, revenue cycle, population health, and data analytics initiatives • Monitor regulatory, coding, and reimbursement changes and communicate impacts across the organization • Analyze documentation and coding trends to identify improvement opportunities • Work closely with clinical leadership, coding teams, health plans, and operational stakeholders • Help drive strategies that improve quality scores, risk adjustment accuracy, and overall organizational performance

🎯 Requirements

• Associate degree required; Bachelor's degree preferred • Certified Risk Coder (CRC) through AAPC or CDI/CCS certification through AHIMA • Minimum of 3 years of experience in Medicare and/or Medicaid Risk Adjustment, including HHS-HCC, CMS-HCC, or DxCG methodologies • Strong experience with ICD-10 coding and clinical documentation review • In-depth knowledge of medical terminology, anatomy, physiology, and disease processes • Expertise in HCC coding and risk adjustment programs • Strong analytical, organizational, and problem-solving skills • Excellent written and verbal communication skills with the ability to educate audiences at all levels • Ability to manage multiple priorities and work independently in a remote environment • Current RN license in good standing (preferred) • Certified Professional Coder (CPC) through AAPC (preferred) • Minimum of 3 years of clinical experience, preferably in a Federally Qualified Health Center (FQHC) or primary care environment • Experience with Epic Electronic Medical Record (EMR) systems (preferred) • Experience supporting value-based care and population health initiatives (preferred) • Applicants must reside and perform work in an approved state at the time of hire and throughout employment • Health Choice Network is not able to employ individuals who reside or work in California

🏖️ Benefits

• 100% Remote Work – Work from anywhere within the United States • 100% Employer-Paid Medical Insurance – Comprehensive medical coverage at no cost to employees on one of our health plans • Generous Paid Time Off (PTO) • 403(b) Retirement Plan with Employer Contribution • Professional Development & Education Assistance – Ongoing learning, certifications, and educational opportunities • Mission-Driven Culture dedicated to strengthening community health and expanding access to quality healthcare services

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