HCC Clinical Documentation Specialist

About the role

We’re looking for experienced and motivated HCC Clinical Documentation Specialists to join our dedicated team in a fully remote capacity. This individual will play a critical role in supporting coding accuracy, HCC capture, regulatory compliance, and clinical documentation integrity, advancing documentation excellence that reflects the patient's true severity of illness and complexity of care.

Responsibilities

• Serve as a subject matter expert in clinical documentation quality, risk adjustment, and HCC coding integrity in the outpatient setting.
• Perform prospective reviews of medical records from physician practices, outpatient settings, and relevant inpatient encounters to validate chronic conditions and ensure documentation accuracy, clinical integrity, appropriate coding, and HCC capture.
• Utilize Epic and OurPractice Advisories (OPAs) to perform prospective chart reviews, identify documentation opportunities, validate chronic conditions, and support accurate coding, HCC capture, and clinical documentation integrity initiatives.
• Track and manage work queues, review inventories, and OPA-related activities to ensure timely follow-up, productivity targets, and accurate completion of CDI interventions.
• Monitor, analyze, and report CDI outcomes, documentation trends, and HCC recapture performance to identify improvement opportunities and support program goals.

Qualifications

• Minimum 2 years of ambulatory Clinical Documentation Integrity, Risk Adjustment, or related healthcare documentation experience.
• Active LPN or RN license required.
• CCDS, CCDS-O, CDIP, CDEO and/or CRC certification strongly preferred.
• Proficiency in Epic workflows, including interpretation and management of OurPractice Advisories (OPAs) preferred.
• Strong understanding of ICD-10-CM coding guidelines and HCC documentation and coding requirements.
• Strong understanding of clinical criteria for HCC diagnoses.
• Excellent communication, critical thinking, and organizational skills.
• Comfortable using MS Office, email, VPNs, virtual machines, two-factor authentication, and video conferencing tools (MS Teams, Zoom, etc.).

Benefits

• Full benefits package.
• Paid time off (PTO).
• Competitive pay.
• Collaborative, mission-driven team environment.
• Opportunities for continuous learning, education, and professional growth.
• Leadership that values your expertise and input.