Clinical Documentation Reviewer (Physician)

Job Overview

This contract role requires working onsite during California business hours (8:00 AM – 5:00 PM PST) with some allowance for schedule flexibility. The primary focus is on clinical documentation review involving medical risk adjustment and hierarchical condition categories (HCC).

Key Responsibilities and Experience

• Perform thorough reviews of clinical documentation to support accurate medical coding and reimbursement processes.
• Apply knowledge of medical risk adjustment methodologies and HCC coding principles.
• Utilize an understanding of medical terminology to ensure documentation accuracy.
• Engage in clinical documentation improvement activities to enhance patient records quality, although prior CDI experience is advantageous but not mandatory.
• Focus on outpatient patient population documentation; prior outpatient clinical exposure is preferred but not obligatory.

Additional Information

This position emphasizes the importance of risk adjustment experience and values candidates with an outpatient clinical background to better support the patient population.