Remote Clinical Risk Adjustment & CDI Specialist

Stryker Corporation; Northern (KY); Hybrid; Confidential; Full time

Benefits offered by this job

Full benefits package

PTO

Top pay

Job summary

UASI is seeking a Clinical Risk Adjustment Documentation Specialist to support coding accuracy, HCC capture, regulatory compliance, and CDI initiatives in a fully remote capacity.

The role requires strong clinical judgment, analytical skills, and a commitment to documentation integrity that reflects patient severity of illness and care complexity. You will work with Epic and OPAs to review records, validate conditions, and monitor CDI outcomes.

Qualifications

• Minimum 2 years of ambulatory Clinical Documentation Integrity, Risk Adjustment, or related healthcare documentation experience.
• Active LPN or RN license required.
• CCDS, CCDS-O, CDIP, CDEO and/or CRC certification strongly preferred.
• Proficiency in Epic workflows, including interpretation and management of OurPractice Advisories (OPAs) preferred.
• Strong understanding of ICD-10-CM coding guidelines, HCC documentation and coding requirements.
• Strong understanding of clinical criteria for HCC diagnoses.
• Excellent communication, critical thinking, and organizational skills.
• Comfortable using MS Office, email, VPNs, virtual machines, two-factor authentication, and video conferencing tools.

Responsibilities

• Serves as a subject matter expert in clinical documentation quality, risk adjustment, and HCC coding integrity in the outpatient setting.
• Performs prospective reviews of medical records from physician practices, outpatient settings, and relevant inpatient encounters to validate chronic conditions and ensure documentation accuracy, clinical integrity, appropriate coding, and HCC capture.
• Utilizes Epic, OurPractice Advisories (OPAs) to perform prospective chart reviews, identify documentation opportunities, validate chronic conditions, and support accurate coding, HCC capture, and clinical documentation integrity initiatives.
• Track and manage work queues, review inventories, and OPA-related activities to ensure timely follow-up, productivity targets, and accurate completion of CDI interventions.
• Monitor, analyze, and report CDI outcomes, documentation trends, and HCC recapture performance to identify improvement opportunities and support program goals.

Skills

Clinical documentation integrity

HCC coding

ICD-10-CM coding

Communication

Analytical thinking

Education

RN license

LPN license

CCDS/CDDS-O/CDIP/CDEO/CRC certifications

Tools

Epic workflows

OPAs (OurPractice Advisories)

MS Office

VPNs / secure access

Video conferencing (MS Teams/Zoom)

Job description

UASI is seeking a Clinical Risk Adjustment Documentation Specialist to support coding accuracy, HCC capture, regulatory compliance, and CDI initiatives in a fully remote capacity.

The role requires strong clinical judgment, analytical skills, and a commitment to documentation integrity that reflects patient severity of illness and care complexity. You will work with Epic and OPAs to review records, validate conditions, and monitor CDI outcomes.