CDI Risk Adjustment Specialist

Mass General Brigham; Somerville (MA); Remote; USD 96,000 - 114,000; Full time

Job summary

A leading healthcare organization is seeking a qualified clinical professional to conduct advanced documentation reviews, ensuring quality outcomes and compliance. Candidates must have a Registered Nurse or equivalent license with significant experience in acute care and clinical documentation improvement. This role offers the potential for remote work and career growth opportunities.

Benefits

Comprehensive benefits package

Career advancement opportunities

Recognition programs

Qualifications

• 5 years of acute medical/surgical care experience required.
• 3-5 years of clinical documentation improvement experience required.
• In-depth knowledge of clinical disease processes and inpatient care delivery.

Responsibilities

• Conduct advanced clinical documentation reviews for inpatient encounters.
• Identify discrepancies and missed opportunities in clinical documentation.
• Issue compliant queries to providers addressing quality initiatives.
• Collaborate with vendor-supported teams to ensure accurate documentation.
• Track and report clinical documentation issues affecting quality measures.

Skills

Analytical skills

Critical thinking

Communication skills

Education

Registered Nurse (RN) license

Certification in Clinical Documentation

Job description

Employer Industry: Healthcare Services

Why consider this job opportunity:

• Salary up to $113,453.60 annually
• Comprehensive benefits package and recognition programs to celebrate contributions
• Opportunities for career advancement and professional growth
• Remote work flexibility
• Work with a team dedicated to improving patient care and outcomes
• Collaborative and supportive work environment

What to Expect (Job Responsibilities):

• Conduct advanced clinical documentation reviews for inpatient encounters focusing on risk-adjusted methodologies
• Identify discrepancies and missed opportunities in clinical documentation impacting quality outcomes
• Issue compliant queries to providers addressing organizational quality initiatives
• Collaborate with vendor-supported teams to ensure accurate clinical documentation
• Track and report clinical documentation issues affecting quality measures

What is Required (Qualifications):

• Registered Nurse (RN), Advanced Practice Clinician (NP/PA), or other clinically licensed professional
• 5 years of acute medical/surgical care experience required
• 3-5 years of advanced clinical documentation improvement experience required
• In-depth knowledge of clinical disease processes and inpatient care delivery
• Strong analytical, critical thinking, and communication skills

How to Stand Out (Preferred Qualifications):

• Certification in Clinical Documentation