Remote Clinical Documentation Improvement Specialist

UnitedHealth Group; Los Alamitos (CA); Remote; USD 73,000 - 130,000; Full time

Benefits offered by this job

Telecommuter Policy

Job summary

UnitedHealth Group is seeking a Clinical Documentation Improvement Specialist to work remotely from anywhere in the U.S. The role focuses on reviewing clinical records for accuracy and coding alignment, and collaborating with physicians to improve documentation.

Candidates may be an RN with 3+ years inpatient CDI experience or a Medical School Graduate with 2+ years CDI experience. Strong communication, ICD-10-CM/PCS, MS-DRG/APR-DRG, and coding guidelines are required.

Qualifications

• Current RN License or Medical School Graduate.
• For RN: 3+ years acute inpatient CDI experience.
• For Medical School Graduates: 2+ years acute inpatient CDI experience.
• Experience communicating & working closely with Physicians.
• Experience performing concurrent inpatient chart reviews and physician query processes.
• Experience with ICD-10-CM/PCS documentation requirements.
• Knowledge of inpatient reimbursement methodologies including MS-DRG and APR-DRG.
• Knowledge of documentation regulations, compliant query practices, and coding guidelines.
• Basic proficiency using Windows, MS Word, MS Excel, and EMR.

Responsibilities

• Provides expert level review of clinical records within 24-48 hours of admission.
• Reviews clinical documentation for consistency with evidence-based guidelines.
• Communicates with providers to reinforce guidelines and accuracy.
• Tracks productivity for reporting and impact analyses.
• Offers education opportunities for physicians and health care team members.
• Follows through on requests for clarification or recommendations.
• Participates in education strategy development for documentation improvement.
• Gives timely feedback to providers on opportunities for improvement.
• Engages Medical Director/leadership as needed to resolve issues.
• Collaborates with Care Coordination and Quality Management on CDI opportunities.
• Operates with a self-directed, unstructured approach to complex issues.

Skills

Physician communication

Chart reviews

Physician queries

ICD-10-CM/PCS

MS-DRG knowledge

Coding guidelines

Remote work

Education

RN License

Medical School Graduate

Tools

Windows OS

Microsoft Word

Microsoft Excel

Electronic Medical Records

Job description

UnitedHealth Group is seeking a Clinical Documentation Improvement Specialist to work remotely from anywhere in the U.S. The role focuses on reviewing clinical records for accuracy and coding alignment, and collaborating with physicians to improve documentation.

Candidates may be an RN with 3+ years inpatient CDI experience or a Medical School Graduate with 2+ years CDI experience. Strong communication, ICD-10-CM/PCS, MS-DRG/APR-DRG, and coding guidelines are required.