Clinical Documentation Specialist

This a Full Remote job, the offer is available from: Philippines

Job Summary:

The ideal candidate will have a strong understanding of healthcare documentation, coding standards, and regulatory requirements to ensure our clients receive optimal reimbursement and maintain compliance.

Key Responsibilities:

• Review clinical documentation to ensure accuracy, completeness, and compliance with industry standards (e.g., ICD-10, CPT, HCPCS).
• Collaborate with physicians, nurses, and other healthcare professionals to clarify ambiguous or incomplete documentation.
• Identify gaps or inconsistencies in documentation and recommend necessary modifications to support accurate coding and billing.
• Serve as a liaison between healthcare providers and coders to ensure documentation supports billed services.
• Monitor documentation trends and provide feedback or training to improve quality and efficiency.
• Assist in audits and compliance reviews to identify areas of risk or improvement.
• Stay updated on payer-specific requirements, CMS guidelines, and documentation best practices.
• Ensure timely review and submission of documentation to meet client billing cycles.

Qualifications:

• Bachelors degree in Nursing, Health Information Management, or related field preferred.
• Certification in Clinical Documentation Improvement (e.g., CCDS, CDIP) is a plus.
• 2+ years of experience in clinical documentation review, medical coding, or healthcare revenue cycle.
• Strong knowledge of medical terminology, anatomy, and disease processes.
• Familiarity with EHR/EMR systems and medical billing software.
• Excellent analytical, communication, and interpersonal skills.
• Strong attention to detail and ability to manage multiple priorities.

Preferred Skills:

• Experience working in a BPO or medical billing outsourcing environment.
• Familiarity with U.S. healthcare billing and insurance systems.
• Ability to work independently and in a team-oriented environment.

This offer from "HCM Nexus" has been enriched by Jobgether.com and got a 72% flex score.