Clinical Documentation Specialist- Outpatient
Remote Opportunity
About Reveleer
Reveleer delivers a unified platform spanning risk adjustment, quality improvement, clinical intelligence, and member management for health plans and provider organizations navigating the complexity of value-based care. Trusted by 80+ customer organizations nationwide, the platform integrates data, analytics, and intelligent workflow automation into one governed system designed to support traceable documentation across diagnoses, quality measures, and submissions. With regulatory expertise and transparent, human-in-the-loop AI at its core, Reveleer supports organizations working to advance care quality, strengthen documentation integrity, and sustain the operational readiness needed to navigate audits with confidence.
Summary/Objective
The clinical documentation specialist (Outpatient) is responsible for facilitating improvement in the overall quality and completeness of Clinical Intelligence's recapture and suspecting performance. The specialist will perform reviews of patient records to identify and validate Hierarchical Condition Category (HCC) diagnoses. The specialist will query providers to ensure accurate and complete documentation that supports HCC and condition-related diagnoses, ultimately enhancing RAF score accuracy and improving risk adjustment outcomes.
Essential Functions
· Apply comprehensive knowledge of medical terminology, disease processes, treatment modalities, diagnostic tests, medications, and procedures to identify gaps in the overall quality and completeness of clinical documentation.
· Validate recapture and suspect conditions based on clinical evidence.
· Validate documentation supports reported conditions.
· Create queries reflective of best practice.
· Formulate recommendations to improve clinical logic and workflows.
· Maintain strict confidentiality of patient information in accordance with privacy regulations.
Competency
· Strong understanding of CMS, HHS, Medicaid, and Rx HCC models.
· Up to date with industry standards related to HCC documentation, ICD-10-CM coding, AHA Coding Clinics, and Official Coding Guidelines.
· Proficient in the use of electronic medical records and technology enabling solutions.
Required Education and Experience
· Graduate of an accredited nursing education program
· Active and unrestricted Registered Nurse or Advanced Practice Provider license
· Certified Documentation Expert-Outpatient (CDEO) or Certified Clinical Documentation Specialist- Outpatient (CCDS-O) or Certified Documentation Improvement Practitioner (CDIP) and Certified Risk Adjustment Coder (CRC)
· Minimum of 2 years outpatient CDI experience
· Experience navigating Epic, Athena, and Cerner EMRs
· 5 years of clinical experience
Preferred Education and Experience
· Bachelor's Degree in Nursing preferred
· Ambulatory clinical experience preferred
WHAT YOU'LL RECEIVE
• Competitive salary
• Medical, Dental and Vision benefits
• 401k match
• Generous PTO plan
Our compensation reflects the cost of labor across several US geographic markets. Pay is based on several factors including market location and may vary depending on job-related knowledge, skills, and experience.
Reveleer E-Verifies all new hires.
Reveleer is an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, gender identity, sexual orientation, age, marital status, veteran status, disability status or genetic information, in compliance with applicable federal, state and local law.
...General Freight Transport Company that is owned and operated by a local family. Were looking for dedicated individuals who are... ...loads safely and punctually You can plan on working about 4-5 days a week, in an 10-12 hour shift Follow strict safety standards...
...square feet, including 600,000 square feet of cleanrooms. Construction will require as much steel as eight Eiffel Towers and as... ...the future talent pipeline Job Summary: The Project Administrative Assistant will provide administrative and operational support to the...
...values and enthusiasm for building a great culture and product, you will find a home at Fieldguide. About the Role Were hiring a Motion Designer to join the Fieldguide team. Youll own the animations, product explainers, and campaign pieces that bring our product and...
...our partnerships without pursuing an internal product pipeline. Since 2009, we have partnered with over 140 pharmaceutical and biotechnology companies, generating more than 650 therapeutic programs, of which more than 85 have entered clinical trials. Role Overview:...
...Earn Cash at Home by Participating in Paid Studies We are seeking people across the country to join paid surveys. You will... ...executing email responses, evaluations, studies, and other online tasks. This work from home possibility is extremely rewarding and will certainly...