Clinical Documentation Improvement Specialist

Clinical Documentation Improvement Specialist

Posted 1 day ago. This remote position is located in the Los Angeles region and requires regular travel within the LA area.

Responsible for conducting retrospective medical reviews to assess medical record documentation and monitoring submitted codes on claim/encounter for Medicare Risk Adjustment.

• Conduct retrospective medical record and claims review to assess documentation practices and accuracy/sufficiency of policies and procedures.
• Verify accuracy/appropriateness of submitted diagnosis codes based on medical record documentation, ensuring details are captured and supported.
• Identify and recommend coding best practices to address unsupported additions/deletions, inconsistencies, and discrepancies.
• Update and develop policies and procedures and training collateral to reflect best practices.
• Conduct ongoing review, monitoring and communications to promote and ensure adherence to established protocols and best practices.
• Review documentation of well visits (annual well visits and other routine and preventative visits) including the use of appropriate modifiers for HEDIS scoring accuracy.
• Conduct ongoing review of medical records/practice notes to validate improvement, identify new opportunities to improve medical record‑keeping, code more accurately, and ensure compliance with coding accuracy and completeness.

• Minimum 2 years of experience coding all types of medical records (including Medicare Risk Adjustment) in a physician practice setting or large group practice.
• Current Certified Professional Coder certification (CPC, CPC‑H, CCS, or CCS‑P) required.
• Additional experience in procedural clinical coding preferred.
• Clinical experience or background (e.g., RN, LPN, foreign medical graduates) preferred.
• Must reside in the Los Angeles region and be able to travel regularly throughout the LA area.
• Compensation for roles in premium or high‑cost geographic markets may exceed this range; position is bonus eligible based on performance.

$74,084.00 – $92,604.50.

Entry level

Full‑time

Health Care Provider

Industries:
Hospitals and Health Care