Job Description

Clinical Documentation Improvement Specialist Join to apply for the Clinical Documentation Improvement Specialist role at Mosaic Health . Role Overview Responsible for conducting retrospective medical reviews to assess medical record documentation and monitor submitted codes on claims/encounters for Medicare Risk Adjustment. Location & Work Arrangement Location: Must reside in Los Angeles, Los Angeles County, or Orange County. This is a hybrid role requiring travel to multiple locations 2 days per week, with 3 days working from home. Primary Responsibilities Conduct retrospective reviews of medical records and claims to assess documentation practices and accuracy. Verify the accuracy and appropriateness of submitted diagnosis codes based on medical record documentation, ensuring details are supported and comprehensive. Identify and recommend coding best practices to address discrepancies and unsupported code changes. Update policies, procedures, and training materials to reflect best practices. Monitor adherence to established protocols and communicate findings regularly. Review documentation of well visits and routine preventive visits, ensuring proper use of modifiers for HEDIS scoring. Continuously review medical records to validate improvements, identify new opportunities, and ensure ongoing coding accuracy and compliance. Requirements Minimum 2 years of coding experience across all medical record types, including Medicare Risk Adjustment, in a physician or large group practice setting. Current Certified Professional Coder (CPC, CPC-H, CCS, or CCS-P) certification required. Experience in procedural clinical coding preferred. Clinical background (e.g., RN, LPN, foreign medical graduates) is preferred. Compensation: $90,160 - $112,700 & bonus eligibility. Additional Details Seniority level: Entry level Employment type: Full-time Job function: Healthcare Provider Industries: Hospitals and Healthcare #J-18808-Ljbffr Mosaic Health

Job Tags

Full time, Work from home, 2 days per week,

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