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Clinical Review Specialist, Remote
5 days agoWhat's your preference?
Job Description
- Req#: RQ4047643
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $90,750.40 annually
- Comprehensive benefits package, including career advancement opportunities
- Flexible remote work arrangement
- Opportunity to educate and impact clinical documentation and coding practices
- Supportive work environment that values team contributions
What to Expect (Job Responsibilities):
- Conduct pre-visit reviews of ambulatory encounters to identify and recapture medical conditions meeting HCC criteria
- Interpret clinical information and present HCC considerations to providers for accurate documentation
- Identify educational opportunities for providers based on chart review findings
- Communicate with care teams using Epic resources to enhance medical record documentation
- Maintain clinical licensure and coding credentials while participating in ongoing education
What is Required (Qualifications):
- Minimum of three (3) to five (5) years' experience in case management, outpatient coding, utilization review, or CDI
- Two (2) years' experience in Primary Care, medical coding, risk adjustment, or CDI preferred
- Current certification in Clinical Documentation Improvement (CDIP, CCDS, CCDS-O, or CDEO) preferred
- Certification in medical coding or risk adjustment (i.e., CRC, CPC, CCS, CDEO) preferred
- Strong PC skills with proficiency in Microsoft applications
How to Stand Out (Preferred Qualifications):
- Experience in clinical documentation improvement or risk adjustment
- Medical licensure (RN, PA, NP) preferred
- Bachelor's degree in a healthcare-related field preferred
- Familiarity with coding literature and guidelines
- Ability to foster collaborative relationships within a healthcare setting
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