Clinical Documentation Specialist- Outpatient

Reveleer
United States
Workplace: RemoteFull timeUSD 85,000 - 120,000 annuallyFunction: Quality & Regulatory (Non-Software)Experience: 2+ yearsSkills: ["Confidentiality","Clinical documentation quality","Provider communication","Attention to clinical detail","Recommendation development"]

Review outpatient patient records to validate and recapture Hierarchical Condition Category (HCC) diagnoses that improve RAF score accuracy and downstream risk adjustment outcomes. Apply deep medical terminology and coding expertise to identify documentation gaps, create provider queries, and recommend workflow improvements. Work with electronic medical record systems (Epic, Athena, Cerner) while maintaining strict patient confidentiality and staying current with CMS/HHS/Medicaid and HCC/ICD-10-CM documentation guidelines.

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Reveleer
Reveleer
19 hours ago

Clinical Documentation Specialist- Outpatient

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Source: Company careers pageValidated by: Fursa AI
Last checked: 13 hours agoStatus: Live

Job Summary

Review outpatient patient records to validate and recapture Hierarchical Condition Category (HCC) diagnoses that improve RAF score accuracy and downstream risk adjustment outcomes. Apply deep medical terminology and coding expertise to identify documentation gaps, create provider queries, and recommend workflow improvements. Work with electronic medical record systems (Epic, Athena, Cerner) while maintaining strict patient confidentiality and staying current with CMS/HHS/Medicaid and HCC/ICD-10-CM documentation guidelines.
Location: United States
Workplace: Remote
Employment Type: Full time
Job Function: Quality & Regulatory (Non-Software)
Seniority: Mid level

Key Responsibilities

  • •Apply comprehensive knowledge of medical terminology, disease processes, treatments, diagnostics, medications, and procedures to identify gaps in clinical documentation quality and completeness.
  • •Validate recapture and suspect conditions based on clinical evidence and ensure documentation supports reported conditions.
  • •Perform reviews of patient records to identify and validate HCC diagnoses.
  • •Create provider queries reflecting best practice to support accurate and complete documentation.
  • •Formulate recommendations to improve clinical logic and workflows while maintaining strict patient confidentiality.

Pay and Benefits

Salary: USD 85,000 - 120,000 annually
Perks:Health InsuranceDentalVision401kPaid Leave

Key Requirements

  • •Graduate of an accredited nursing education program and hold an active, 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) plus Certified Risk Adjustment Coder (CRC).
  • •Minimum of 2 years outpatient CDI experience.
  • •Strong understanding of CMS, HHS, Medicaid, and Rx HCC models and up-to-date knowledge of HCC documentation and ICD-10-CM coding guidelines.
  • •Experience navigating Epic, Athena, and Cerner electronic medical record (EMR) systems.
Experience:2+ years
Education:
Skills:ConfidentialityClinical documentation qualityProvider communicationAttention to clinical detailRecommendation development
Licenses:Registered Nurse (RN) licenseAdvanced Practice Provider license
Certifications:CDEOCCDS-OCDIPCRCCertified Risk Adjustment Coder (CRC)
Tech Stack:EpicAthenaCernerElectronic medical recordsICD-10-CMCMSHCCAHA Coding ClinicsOfficial Coding Guidelines

Company Brief

Reveleer
Provides an AI-powered value-based care platform for health plans and risk-bearing providers, offering retrieval, clinical intelligence, risk adjustment, quality improvement, and member management solutions to streamline workflows and improve outcomes.
Industry: HealthTech
Company Size: Large (251 to 1,000 employees)
Growth: Scaleup
Funding: Private Equity Backed
Headquarters: Glendale, United States
Founded: 2009
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