Remote CDI Specialist: Risk Adjustment & Documentation

Health Choice Network, Inc.; United States; Remote; USD 70,000 - 85,000; Full time

Benefits offered by this job

100% Remote Work

100% Employer-Paid Medical Insurance

Generous PTO

403(b) Retirement Plan with Employer #

Job summary

Health Choice Network, Inc. is hiring a Clinical Documentation Improvement (CDI) Specialist to drive documentation quality, risk adjustment, and coding accuracy across the organization. This fully remote role focuses on Medicare/Medicaid risk adjustment and provider education.

You will collaborate with clinical leaders and coders to review records for HCC coding accuracy, and develop training materials to improve documentation quality while supporting value‑based care goals.

Qualifications

• CRC or CDI/CCS certification required.
• Three years of Medicare/Medicaid Risk Adjustment experience.
• Strong ICD-10 coding and clinical documentation review knowledge.
• Knowledge of HHS-HCC, CMS-HCC, or DxCG methodologies.

Responsibilities

• Serve as SME on ICD-10-CM coding guidelines and Risk Adjustment methodologies.
• Conduct proactive medical record reviews for documentation quality and coding accuracy.
• Ensure conditions are accurately documented to support risk stratification and quality care.
• Identify trends impacting patient risk scores and value-based care performance.
• Develop and deliver education programs for providers and coders.
• Collaborate with health plans on risk adjustment initiatives and audits.
• Monitor regulatory changes affecting coding and reimbursement.

Skills

ICD-10 Coding

Risk Adjustment

Clinical Documentation Improvement

Medicare/Medicaid Knowledge

Provider Education

Remote Work

Communication

Education

CRC (AAPC) or CDI/CCS (AHIMA)

CPC (AAPC)

Tools

Epic EMR

Job description

Health Choice Network, Inc. is hiring a Clinical Documentation Improvement (CDI) Specialist to drive documentation quality, risk adjustment, and coding accuracy across the organization. This fully remote role focuses on Medicare/Medicaid risk adjustment and provider education.

You will collaborate with clinical leaders and coders to review records for HCC coding accuracy, and develop training materials to improve documentation quality while supporting value‑based care goals.