Remote Clinical Documentation Integrity Specialist (Bilingual in Spanish/English)

This position supports both English and Spanish-speaking providers and care teams. The ideal candidate is fully bilingual in Spanish and English and is able to review Spanish-language medical documentation, communicate effectively with providers in both languages, and ensure accurate, compliant translation of clinical concepts into coding practices.

Duties and Responsibilities 

• Review clinical documentation to ensure accurate, complete, and compliant coding in accordance with ICD-10-CM, HCC, and regulatory guidelines.
• Serve as the subject matter expert on outpatient risk adjustment documentation and HCC coding requirements.
• Conduct Clinical Documentation Integrity (CDI) reviews and Quality reviews to ensure accurate capture of quality measures and risk adjustment data.
• Query providers for documentation clarification while maintaining compliance with coding and documentation standards.
• Analyze documentation trends and identify opportunities for provider education, workflow improvements, and operational optimization.
• Develop and deliver ongoing education and training to providers on documentation best practices and coding requirements.
• Build strong collaborative relationships with providers and cross-functional teams across the organization.
• Assist leadership with analysis, trending, reporting, and presentation of audit findings and documentation improvement opportunities.
• Review and interpret Spanish-language medical records to ensure accurate ICD-10 and CPT coding.
• Communicate effectively in both Spanish and English with providers and care team members regarding documentation questions and coding guidance.
• Identify documentation trends within Spanish-language records and communicate findings to stakeholders to improve coding accuracy and risk capture.
• Support bilingual care teams by translating or clarifying documentation-related concepts while maintaining compliance standards.
• Provide documentation guidance to Spanish-speaking frontline Care Navigators as needed.
• Assist with translating documentation education and training materials for Spanish-speaking providers and care teams.
• Maintain confidentiality of patient information and adhere to all company policies and compliance requirements.
• Support Duo Health's continuous quality improvement initiatives.

Requirements 

• Minimum of 5 years of Clinical Documentation Integrity (CDI) and Quality experience.
• Minimum of 3 years of outpatient risk adjustment CDI experience.
• Fluency in both spoken and written Spanish and English is required.
• Ability to read, interpret, and analyze clinical documentation written in Spanish.
• Ability to communicate effectively with clinicians and internal teams in both English and Spanish.
• Strong knowledge of ICD-10-CM coding, HCC risk adjustment methodology, medical terminology, disease processes, pharmacology, and clinical documentation standards.
• Experience independently managing projects and driving documentation improvement initiatives.
• Bachelor's degree in nursing preferred; equivalent education and experience will be considered.
• CCS, CRC, CPC, CCDS, or CDIP certification preferred.
• Strong analytical, organizational, and critical thinking skills with exceptional attention to detail.
• Comfortable working independently in a fast-paced, remote environment.
• Excellent written and verbal communication skills.
• Ability to build strong working relationships and collaborate effectively in a virtual environment.
• All required certifications and credentials must remain active and current.

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
• 401(k) plan with company matching
• 12 Paid holidays 
• A mission-driven approach to everything we do, with an overall goal of improving health equity and health outcomes.