Clinical Documentation Integrity Specialist (Bilingual in Spanish/English)

As the Clinical Documentation Integrity Specialist, you will play a critical role in creating a culture of best-in-class clinical documentation accuracy in support of building a model of care focused on quality and health outcomes. You will work closely with our Coding Specialist, Medical Group Operations, Revenue Cycle Management, and Compliance teams to leverage your coding and documentation expertise to foster improvements in the overall quality, completeness, and compliance of clinical documentation. You will serve as the subject matter expert on HCC documentation requirements and ICD-10-CM coding guidelines. 

Duties and Responsibilities 

• The Clinical Documentation Improvement (CDI) Specialist at Duo Health will be responsible for ensuring Duo’s Burden of Illness team members and providers meet coding rules, query compliance, and company compliance guidelines 

• The CDI specialist will also perform assessments of data to improve overall operations and identify opportunities for provider education and optimization 

• You will perform Quality reviews in conjunction with CDI reviews to ensure that Quality measures are also captured accurately 

• You will serve as a subject matter expert on HCC documentation requirements and ICD-10-CM coding guidelines 

• You will query providers to ensure that appropriate documentation appears in the medical record while maintaining compliance in all aspects of work 

• Develop and support strong professional relationships with medical providers across the organization 

• Conduct ongoing education and training for providers on proper documentation and coding 

• Assist leaders with analysis, trending, and presentation of audit / review findings, outcomes, and issues 

Requirements 

• You have 5+ years of overall CDI and Quality experience, and 3+ years of outpatient risk adjustment CDI specific experience  

• Must be an RN with an active license

• You perform frequently without supervision and can drive projects and problem statements 

• Bachelor’s degree in Nursing preferred; however, an equivalent combination of education and experience that provides proficiency in the areas of responsibility, may be substituted for the stated education and experience requirements 

• CCS, CRC, CPC, CCDS or CDIP certifications

• Strong knowledge of medical terminology, physiology, pharmacology, disease processes and related procedures and critical thinking skills 

• Knowledge of risk adjustment (HCCs), guiding principles, and reimbursement methodology 

• You flourish in fast-paced environments, work independently, and can identify your own 

• opportunities for success 

• You have great attention to detail, are data-driven, and is tech-savvy 

• Excellent written and verbal communication skills and critical thinking skills 

• Strong ability to effectively build relationships and collaborate with coworkers and clinicians in a remote setting 

• It is expected that all certifications, licenses, etc. are renewed by the expiration date to remain compliant  

Working for Duo 

• 100% remote working environment 

• Competitive medical, dental and vision plans 

• Paid maternity and paternity leave 

• Adoption Assistance 

• Access to free wellness & personal development courses 

• 401k plan with company matching 

• Paid holidays and paid time off 

• A mission-driven approach to each and everything that we do, with an overall goal to improve health equity and health outcomes.