Clinical Documentation Integrity Specialist

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🔥 1 hour ago

🏄 California – Remote

🏄 California – Remote

💵 $100.2k - $218.7k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥📝 Medical Writer

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UCLA Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1955

🏥 Healthcare

📚 Education

🔬 Science

Healthcare • Education • Science

UCLA Health is an integrated academic health system anchored by the UCLA School of Medicine that delivers patient care, medical education, and clinical research across Southern California. With more than 290 locations including hospitals, specialty clinics, and immediate/primary care sites, UCLA Health provides a wide range of services—cancer care, transplant, neuroscience, orthopedics, heart and vascular, pediatrics, women's health, psychiatry and more—while offering virtual care, clinical trials, and patient resources such as myUCLAhealth. The organization emphasizes advanced technology, research-driven treatments, community engagement, and top-ranked hospital patient care outcomes.

📋 Description

• Make a positive impact on one of the nation’s top health systems • Help ensure the efficient delivery of award-winning patient care • Take your professional expertise to the next level • Become a member of a highly successful Clinical Documentation Integrity and Denial Management team • Involve daily review of high-acuity patient records to identify potential and active payer denials • Assess clinical validity • Support denial prevention, analysis, and appeals across inpatient and outpatient settings • Continuously communicate with department staff • Educate physicians, residents, and mid-levels • Assist with appropriate documentation strategies • Partner with Medical Coding, Clinical Documentation Integrity, Case Management, and Quality team • Gather/analyze information to provide comprehensive medical record documentation • Ensure accuracy and completeness of clinical documentation for denial prevention • Prepare and submit high quality appeal letters supported by clinical evidence, regulatory guidelines, and payor-specific medical necessity criteria • Identify denial trends and root causes and provide feedback to the CDI and Clinical teams

🎯 Requirements

• Bachelor’s degree in health-related field, preferred • A Registered Nurse (RN) license or MD diploma (or equivalent) required • Three or more years of Clinical Documentation Integrity experience required, preferably at an AMC • Knowledge of coding guidelines and coding clinic, required • Knowledge of laws, rules and regulations regarding appropriate clinical documentation for Medicare, Medi-Cal, CCS etc. • Strong leadership, supervisory, and training skills • Excellent critical thinking abilities • Experience working within EPIC and 3M 360 Encompass CAC, required • Resourcefulness and strong communication, organizational, and analytical skills • Ability to work effectively with physician/staff and interdisciplinary teams • Computer proficiency and proficiency in Word, Excel and PowerPoint, required • Skill in abstracting/interpreting medical information from patient records, required • Clinical experience sufficient to understand and communicate medical diagnoses and courses of treatment to professional and non-professional personnel, required • Knowledge of computer word processing, database programs, and ability to write reports and do graphical analysis, required