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Duly Health and Care · 4 days ago

Clinical Documentation Specialist

Downers Grove, IL

Full-time

Onsite

Entry, Mid Level

$86K/yr - $100K/yr

2+ years exp

Duly Health and Care is seeking a Clinical Documentation Specialist who will support providers through education, training, and ongoing support in condition identification, documentation, and coding. The role involves ensuring compliance with CMS guidelines, facilitating onboarding, and developing improvement plans based on audits and coding metrics.

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Responsibilities

Provides education and training to providers on accurate condition identification, documentation, and coding practices

Ensures compliance with CMS, HCC, and ICD-10 documentation guidelines

Conducts onboarding and ongoing training for new and established providers

Develops and facilitates education sessions, bootcamps, and mini-bootcamps, including evenings or weekends as required

Reviews documentation for accuracy, completeness, and active diagnosis validation

Identifies missing treatment plans and chronic conditions requiring attention

Provides timely feedback and education to providers based on audit findings

Acts as a resource for Providers and vendors

Keeps abreast of current coding trends and maintains up to date knowledge of Medicare rules and regulations regarding diagnosis coding and CDI current trends

Effectively utilizes ICD and related materials to investigate coding issues and produce accurate results

Serves as an expert resource in reviewing all medical records in support of accurate documentation for all payer types to assure complete and accurate diagnosis and procedure capture and coding

Reviews payer files and integrates findings into training and other educational materials

Proactively coordinates and engages regular meetings with providers (Primary Care and Specialists)

Leads and executes physician education strategies that result in improved clinical documentation and complete capture of diagnosis coding

Contributes to the creation, revision, and implementation of playbooks, policies, and procedures

Assists in developing new training content and clinical education materials

Prepares and presents on risk adjustment, HCC, and documentation best practices

Ensures educational resources remain current with industry and regulatory changes

Provide education on HCC conditions

Supports, monitors, and reports key performance indicators (KPIs) to Management and Senior Management

Monitors trends in documentation including prevalence of conditions, develops and implements action plans to maximize the program

Reviews documentation and creates documentation feedback for each provider. Also is able to present this feedback back to the provider and track improvement

Develops and implements strategies, provides analysis and makes recommendation for process improvement using data anysis

Develops monitoring tools to track progress of the program such as identification of cases with suspect opportunities, HCC recapture rate, etc

Builds and maintains collaborative relationships with providers, office managers, and internal teams

Serves as a subject matter expert and trusted advisor in documentation and coding practices

Supports communication between providers, medical office managers, and operations

Participates in weekly team meetings and collaborates on program development

Other duties as assigned

Qualification

Clinical DocumentationRisk AdjustmentICD-10 CodingCPC CertificationRN LicenseTraining SkillsCommunication SkillsOrganizational Skills

Required

Bachelor's degree highly preferred

Active RN license in good standing or Foreign Medical Graduate with MD (full or limited)

CPC or CRC certification (or ability to obtain within 6 months)

Preferred

Minimum 2 years of experience in risk adjustment and/or clinical documentation

Benefits

Comprehensive medical, dental, and vision benefits that include healthcare navigation assistance.

Access to a mental health benefit at no cost.

Employer provided life and disability insurance.

$5,250 Tuition Reimbursement per year.

Immediate 401(k) match.

40 hours paid volunteer time off.

A culture committed to community engagement and social impact.

Up to 12 weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members once eligibility requirements are met.