Clinical Documentation Improvement Specialist - Remote

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

Primary Responsibilities

• 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

Required Qualifications

• Undergraduate degree or equivalent experience
• 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 Records

Preferred Qualifications

• If RN, BSN degree
• Current certification as a CCDS, CDIP or CCS
• Excellent verbal and written skills including solid organizational skills

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

The salary for this role will range from $72,800 - $130,000 annually based on full-time employment.