- Saginaw, Michigan, United States
- 3+ years
Supports accurate, complete, and compliant clinical documentation to ensure appropriate risk adjustment capture and high-quality patient records.
Responsibilities
- Perform concurrent, prospective, and retrospective chart reviews for clinical documentation improvement
- Identify documentation gaps related to HCCs, MEAT criteria, and chronic condition specificity
- Ensure diagnoses are clinically supported, clearly documented, and compliant
- Collaborate with coding staff to resolve documentation discrepancies
- Educate physicians and APPs on HCC documentation standards, annual condition confirmation, and CMS and payer risk adjustment requirements
Requirements
- Bachelor’s degree in nursing
- Nice to have: behavioral health conditions
- Nice to have: mental health risk assessment
- Nice to have: patient education
- Nice to have: Epic experience