Remote Clinical Documentation Integrity Expert

UCLA Health; Los Angeles (CA); On-site; USD 100,000 - 219,000; Full time

Job summary

UCLA Health in Los Angeles is seeking a Clinical Documentation Integrity and Denial Management specialist. The role involves daily review of high-acuity patient records to identify potential payer denials, assess clinical validity, and support denial prevention and appeals across inpatient and outpatient settings.

You will partner with Medical Coding, CDI, Case Management, and Quality teams to ensure documentation reflects treatment and diagnoses, leveraging your CDI and coding knowledge, EPIC,

Qualifications

• Bachelor’s degree in health-related field preferred.
• RN license or MD diploma required.
• 3+ years CDI experience required, preferably AMC.
• Knowledge of coding guidelines and coding clinic.
• Familiarity with Medicare, Medi-Cal, CCS rules.
• Strong leadership and training skills.
• Experience with EPIC and 3M 360 Encompass CAC.
• Proven communication, organizational, and analytical abilities.

Responsibilities

• Daily review of high-acuity patient records to identify payer denials.
• Assess clinical validity and support denial prevention, analysis, and appeals.
• Collaborate with CDI, Medical Coding, Case Management, and Quality teams.
• Prepare appeal letters with clinical evidence and guidelines.

Skills

CDI experience

Clinical terminology

Leadership

Communication

Analytical skills

Team collaboration

Education

Bachelor’s degree in health-related field

RN license or MD diploma

Tools

EPIC

3M 360 Encompass CAC

Job description

UCLA Health in Los Angeles is seeking a Clinical Documentation Integrity and Denial Management specialist. The role involves daily review of high-acuity patient records to identify potential payer denials, assess clinical validity, and support denial prevention and appeals across inpatient and outpatient settings.

You will partner with Medical Coding, CDI, Case Management, and Quality teams to ensure documentation reflects treatment and diagnoses, leveraging your CDI and coding knowledge, EPIC,