Note: The job is a remote job and is open to candidates in USA. Louisiana Blue is committed to improving the health and lives of Louisianians, and they are seeking a Senior Clinical Documentation Integrity Specialist. This role is responsible for ensuring accurate clinical documentation and collaborating with various teams to drive quality and compliance in healthcare documentation.
Responsibilities
- Develops and implements standard processes, job aids, and error prevention tools to strengthen clinical documentation integrity across participating practices
- Educates providers and office staff on best-practice clinical documentation standards to ensure accuracy, completeness, and compliance
- Conducts prospective and retrospective reviews and prepares analyses and reports to identify trends, gaps, and improvement opportunities
- Provides guidance and consultation to internal practice staff to improve coding proficiency and documentation accuracy
- Collaborates with population health and practice teams to support quality programs, value-based initiatives, and standardized data abstraction processes
- Advises practice staff on compliance with applicable federal, state, and local regulations related to Medicare coding and documentation guidelines
Skills
- Bachelor's degree in Nursing or a related field (4 years of related experience can be used in lieu of degree)
- Minimum of 5 years of experience in Clinical Documentation Integrity (CDI) or coding
- At least 3 years of experience supporting healthcare value-based programs, including Medicare Risk (experience may run concurrently)
- A certification, such as CPC, CRC, CCS‑P, CCS‑H, RHIT, CCDS, or CDIP, is required or must be obtained within 12 months of hire
- Advanced knowledge of ICD‑10 coding guidelines and clinical documentation standards
- Strong understanding of CMS quality programs, HCCs, value‑based care models, and EHR systems
- Excellent written, verbal, interpersonal, and presentation skills
- Advanced proficiency in Microsoft Office applications (Excel, Word, PowerPoint, Outlook)
- Strong critical thinking, problem‑solving, and time‑management skills
- Master's degree in Nursing, Advanced Practice Registered Nurse (APRN), or Information Management Professional (MIM)
- Advanced knowledge of preventive health standards and clinical standards of care
- Experience collaborating with population health teams and multi‑disciplinary clinical stakeholders
Company Overview
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