Clinical Risk Adjustment Documentation Specialist

🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🎲 Risk

👻 Ghost score 12%

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UASI

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1984

🏥 Healthcare

💼 Consulting

🤝 B2B

💰 $7M Debt on 2020-05

Healthcare • Consulting • B2B

UASI is a healthcare-focused revenue cycle consulting and services firm that helps hospitals and health systems optimize coding, clinical documentation improvement (CDI), denials and revenue integrity, quality and risk management, and AI adoption. With 40+ years of experience, UASI offers consulting, program design and implementation, assessments and audits, managed services and staffing, technology, and education and training. The company serves more than 1,250 hospital facilities and physician groups and employs 800+ nationally credentialed experts; it is KLAS-recognized and positions itself to find and fill gaps, fix processes, or run functions on behalf of clients (domestic, offshore, or both).

📋 Description

• Serve as a subject matter expert in clinical documentation quality, risk adjustment, and HCC coding integrity in the outpatient setting • Perform prospective reviews of medical records from physician practices, outpatient settings, and relevant inpatient encounters • Validate chronic conditions and ensure documentation accuracy, clinical integrity, appropriate coding, and HCC capture • Use Epic and OurPractice Advisories (OPAs) to perform prospective chart reviews and identify documentation opportunities • Track and manage work queues, review inventories, and OPA-related activities • Ensure timely follow-up, productivity targets, and accurate completion of CDI interventions • Monitor, analyze, and report CDI outcomes, documentation trends, and HCC recapture performance • Identify improvement opportunities and support program goals

🎯 Requirements

• Minimum 2 years of ambulatory Clinical Documentation Integrity, Risk Adjustment, or related healthcare documentation experience • Active LPN or RN license required • CCDS, CCDS-O, CDIP, CDEO and/or CRC certification strongly preferred • Proficiency in Epic workflows, including interpretation and management of OurPractice Advisories (OPAs) preferred • Strong understanding of ICD-10-CM coding guidelines and HCC documentation and coding requirements • Strong understanding of clinical criteria for HCC diagnoses • Excellent communication, critical thinking, and organizational skills • Comfortable using MS Office, email, VPNs, virtual machines, two-factor authentication, and video conferencing tools (MS Teams, Zoom, etc.)

🏖️ Benefits

• Full benefits package • PTO • Top pay • Collaborative, mission-driven team environment • Opportunities for continuous learning, education and professional growth • Leadership that values your expertise and input

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