Ambulatory Clinical Documentation Integrity Specialist (Healthcare)

TL;DR

Ambulatory Clinical Documentation Integrity Specialist (Healthcare): Ensuring clinical documentation accuracy and completeness for ambulatory patients with an accent on HCC risk adjustment and provider collaboration. Focus on validating diagnosis codes, performing quality reviews of medical records, and ensuring compliance with federal and state healthcare regulations.

Location: Remote (USA)

Salary: $75,592 – $113,389

Company

hirify.global is a large integrated healthcare delivery system dedicated to compassionate, person-centered care.

What you will do

• Collaborate with providers and coding staff to ensure documentation accurately reflects the level of service rendered.
• Validate the assignment of HCC diagnoses affecting RAF scores within the ambulatory patient population.
• Conduct prospective and retrospective quality reviews of patient records to identify and resolve documentation discrepancies.
• Ensure medical record documentation is complete, compliant, and supports medical necessity.
• Analyze patterns and trends impacting documentation and coding to act as a technical resource for the service area.
• Maintain adherence to federal, state, and local laws and organizational compliance programs.

Requirements

• Associate’s degree in Business, Healthcare, Nursing, or a related field.
• Experience with compliant healthcare documentation, HCC coding, and revenue cycle or consulting.
• Professional credential in CRC, CDI, CCDS-O, CDEO, or CDIP.
• Must be authorized to work in the US and comply with US federal and state healthcare regulations.

Nice to have

• Bachelor’s degree in Nursing, HIM, or a related healthcare field.

Culture & Benefits

• Mission-driven environment focusing on dignity, diversity, and compassionate care.
• Remote work flexibility.
• Inclusive workplace as an Equal Opportunity Employer.