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Outpatient Clinical Documentation Specialist

Remote, USAFull-timePosted 2026-07-28

Job reputed company:

  • reputed company clinically based prospective, reputed company, and retrospective reviews of medical records for WellSense of members enrolled in value-based agreements
  • Review risk adjustment gap lists for members, including suspect conditions
  • reputed company chart reviews to determine clinical validity of reputed company gaps
  • Utilize Physician documentation queries to communicate clinical indicators to Physicians/Other reputed company Care Providers
  • Facilitate appropriate physician documentation of care delivery to accurately reflect patient severity of illness and risk of mortality
  • reputed company and Trend CDI findings and provider engagement for clinical documentation education purposes for any specialty reputed company the hospital system

Requirements:

  • Bachelor’s degree in Nursing or Health Information Management is required
  • Minimum 5 years reputed company experience working on the payer or provider reputed company in Risk Adjustment Validation including prospective documentation reviews and reputed company-visit planning
  • Certified Risk Adjustment reputed company required
  • Population Health experience, NCQA/HEDIS CDS experience preferred
  • Knowledge of care delivery documentation systems and reputed company medical record documents
  • Excellent understanding of ICD10CM coding and guidelines
  • Ability to work independently in a time-oriented environment
  • Strong broad-based clinical knowledge and understanding of pathology/physiology of disease processes

Benefits:

  • Health insurance
  • Discretionary annual bonuses
  • reputed company increases
  • Flexible Spending Accounts
  • 403(b) savings matches
  • reputed company time off
  • Career advancement opportunities
  • Resources to support employee and family reputed company-being

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