Remote HCC CDI Specialist - Clinical Documentation Expert

UASI; United States; On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Full benefits package

PTO

Top pay

Job summary

UASI is seeking an experienced HCC Documentation Specialist to join our team remotely in the United States. The role emphasizes improving documentation integrity, accurate HCC capture, and regulatory compliance, with strong clinical judgment and analytical skills essential for success.

You will review records from outpatient settings, leverage Epic/OPAs, and collaborate across teams to ensure true severity of illness is reflected in documentation.

Qualifications

• Minimum 2 years ambulatory CDI 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 and OPAs preferred.
• Strong understanding of ICD-10-CM, 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 (MS Teams, Zoom, etc.).

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 to validate chronic conditions and ensure documentation accuracy, clinical integrity, appropriate coding, and HCC capture.
• Utilizes Epic and 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.
• Tracks and manages work queues, review inventories, and OPA-related activities to ensure timely follow-up, productivity targets, and accurate completion of CDI interventions.
• Monitors, analyzes, and reports CDI outcomes, documentation trends, and HCC recapture performance to identify improvement opportunities and support program goals.

Skills

Communication

Critical thinking

Organizational skills

Clinical documentation integrity

Analytical skills

Education

Active LPN or RN license

CDS/CDS-O/CDIP/CDEO/CRC certification preferred

Tools

Epic

OurPractice Advisories (OPAs)

MS Office

VPNs

Video conferencing (MS Teams/Zoom)

Job description

UASI is seeking an experienced HCC Documentation Specialist to join our team remotely in the United States. The role emphasizes improving documentation integrity, accurate HCC capture, and regulatory compliance, with strong clinical judgment and analytical skills essential for success.

You will review records from outpatient settings, leverage Epic/OPAs, and collaborate across teams to ensure true severity of illness is reflected in documentation.