Clinical Documentation NP Specialist

The Medical College of Wisconsin, Inc.; Wisconsin; Hybrid; USD 110,000 - 150,000; Full time

Job summary

The Professional Billing CDI Clinical Specialist at The Medical College of Wisconsin, Inc. partners with CDI, coding, physician advisors, informatics, analytics, and revenue cycle leaders to optimize documentation within provider workflows.

This APP-level role combines clinical judgment with workflow design to ensure documentation supports accurate coding and reimbursement while remaining clinically relevant and practical.

Qualifications

• Minimum required education: Master's or Doctoral degree in nursing or other advanced practice discipline.
• Minimum required experience: 5 years of recent clinical practice.
• Active Advanced Practice Provider license/certification per organizational requirements.
• Preferred: CDI, coding, informatics, or documentation improvement knowledge; coding/CDI certification is a plus.

Responsibilities

• Independent clinical assessment of documentation to ensure accurate reflection of diagnostic reasoning and medical necessity.
• Provide peer-level consultations to physicians and APPs on clinical documentation and medical necessity.
• Evaluate how documentation workflows affect patient care delivery and care coordination.
• Serve on documentation governance committees and advise leadership on clinical implications.
• Perform advanced review of chronic condition documentation and HCC capture opportunities.
• Conduct clinical validation reviews for population health and risk adjustment initiatives.
• Engage providers to identify workflow barriers and integrate documentation improvements into practice.
• Approve and validate provider documentation tools and templates; collaborate with IT and informatics.
• Collaborate with physician advisors, reimbursement leaders, and analysts to align documentation with financial goals.

Skills

Clinical workflows

Documentation practices

Pathophysiology

Medical decision making

Interpersonal skills

Facilitation

Change management

Provider education

EHR proficiency

EPIC (preferred)

Microsoft Office

Education

Master's or Doctoral degree in nursing or applicable APR discipline

Tools

EPIC

Microsoft Office

Job description

The Professional Billing CDI Clinical Specialist at The Medical College of Wisconsin, Inc. partners with CDI, coding, physician advisors, informatics, analytics, and revenue cycle leaders to optimize documentation within provider workflows.

This APP-level role combines clinical judgment with workflow design to ensure documentation supports accurate coding and reimbursement while remaining clinically relevant and practical.