Clinical Documentation Improvement Specialist - Remote

Improve the lives of others while Caring. Connecting. Growing together.

Job Description
- Clinical Documentation Improvement Specialist
- Remote (2393172)

Clinical Documentation Improvement Specialist
- Remote - 2393172

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities.

Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Jobs in this function provide coding and coding auditing services directly to providers. This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes.
* Employees in jobs labeled with ‘SCA’ must support a government Service Contract Act (SCA) agreement.

You’ll enjoy the flexibility to work remotely
* from anywhere within the U.S. as you take on some tough challenges.

• Provides expert level review of clinical records within 24-48 hours of admission; reviews clinical documentation to ensure consistency and alignment with evidence-based guidelines
• Conducts clear communication to providers to reinforce evidence-based guidelines are being followed
• Effectively tracks productivity to allow for accurate/timely reporting of leading indicators and future impact analyses
• Provides expert level leadership for overall improvement in clinical documentation by providing proficient level review and assessment, and effectively articulating recommendations for improvement, and the rationale for the recommendations
• Provides educational opportunities for physicians and other health care team members
• Provides complete follow through on all requests for clarification or recommendations for improvement
• Participates in the development and execution of education strategies resulting in improved clinical documentation
• Provides timely feedback to providers regarding clinical documentation opportunities for improvement and successes
• Engages and consults with Medical Director/leadership when needed, per the escalation process, to resolve issues regarding answering clarifications and participation in the clinical documentation improvement process
• Actively engages with Care Coordination and the Quality Management teams to continually evaluate and spearhead clinical documentation improvement opportunities
• Generally work is self-directed and not prescribed
• Works with less structured, more complex issues
• Serves as a resource to others

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

• Current RN License or Medical School Graduate
• For RN: 3+ years acute inpatient CDI experience
• For Medical School Graduates: 2+ years of acute inpatient CDI experience
• Experience communicating & working closely with Physicians
• Experience performing concurrent inpatient chart reviews and physician query processes
• Experience working with ICD-10-CM/PCS documentation requirements
• Knowledge of inpatient reimbursement methodologies including MS-DRG and APR-DRG systems
• Knowledge of documentation regulations, compliant query practices, and coding guidelines
• Basic proficiency using a PC in a Windows environment, including Microsoft Word, Excel, and Electronic Medical…