Clinical Documentation Improvement Specialist
$72.8k - $130kOptum
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Provides expert level review of inpatient clinical records within 24-48 hours of admit; Actively communicates with providers at all levels, to clarify information and to communicate documentation requirements for appropriate diagnoses based on severity of illness and risk of mortality Performs regular rounding with unit-based physicians and provides Working DRG lists to Care Coordination Ensures effective utilization of Optum® CDI 3D Technology to document all clarification activity Proactively develops a reciprocal relationship with the HIM Coding Professionals Coordinates and conducts regular meeting with HIM Coding Professionals to reconsolidate DRGs, monitor retrospective query rates and discuss questions related to Coding and CDI Actively engages with Care Coordination and the Quality Management teams to continually evaluate and spearhead clinical documentation improvement opportunities You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. 5+ years of acute care hospital clinical RN experience OR Medical Graduate with CDI experience ~ Advanced level of proficiency in clinical medicine, pathophysiology, and pharmacology ~ Intermediate level of proficiency using a PC in a Windows environment, including Microsoft Word, Excel, Power Point and Electronic Medical Records 3+ years of CDI experience for an acute care hospital ~ CAC experience (Computer Assistant Coding) Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Groupis a drug - free workplace.
$72.8k - $130k
...The work you do with our team will directly improve health outcomes by connecting people with... ...Provides expert level review of inpatient clinical records within 24-48 hours of admit; identifies gaps in clinical documentation that need clarification for accurate code assignment...SuggestedMinimum wageFull timeWork experience placementLocal area$72.8k - $130k
...number: 2388997 Job category: Medical & Clinical Operations Optum is a global... ...work you do with our team will directly improve health outcomes by connecting people with... ...of admit; identifies gaps in clinical documentation that need clarification for accurate code...SuggestedMinimum wageFull timeWork experience placementLocal area$46.27 - $60.73 per hour
...physicians, nursing, and other clinical staff. Meets established... ...of medical record documentation. Designs and implements in... ...for clinical documentation improvement. Identifies strategies for... ...required) A Certified Coding Specialist (CCS), Certified Coding Associate...SuggestedHourly payFull timeWork experience placementLocal area- ...Korea including CHA Fertility Center, a medical university, and CHAUM (a premier anti-aging life center). The Clinical Documentation Improvement (CDI) Specialist is responsible for ensuring the accuracy, completeness, and clinical validity of medical record documentation...SuggestedFull timeWork experience placementLocal areaShift work
$71.7k - $105k
...working together to coordinate care, remove barriers, and improve quality of life for some of the most medically and... ...shared commitment to honoring what matters most. The Clinical Documentation Integrity (CDI) Specialist supports accurate, complete, and clinically specific...Suggested- ...the accuracy of the clinician’s documentation, coding requirements and... ...overall quality and completeness of clinical documentation of the patient medical... ...Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Practitioner Certificate (DIP):...Work experience placementWork at officeLocal area
$2,454 per week
Job Overview Travel nurse RN Clinical Document Improvement Specialist located in Tarzana, California. Specialty: Clinical Document Improvement Specialist Discipline: RN Start Date: 05/04/2026 Duration: 13 weeks Hours: 40 hours per week Shift: 8 hours, days Employment...Shift work- ...The Clinical Documentation Specialist (CDS) II is a more experienced CDS, spending at least 75% of their time on independent reviews without supervision... ...credible clinical documentation clarifications to improve clinical documentation of principal diagnosis, co-morbidities...
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$21 - $22 per hour
...Altais:At Altais, we’re on a mission to improve the healthcare experience for everyone—starting... ...Group Riverside, and Family Care Specialists. Together, we’re building a stronger, more... ...by performing administrative and clinical functions within patient flow aligned within...Hourly payFull timePart timeWork at officeLocal areaWork from homeHome office$130k - $145k
...over 125 countries worldwide. Job Summary As a Lean Process Improvement Specialist you'll have the exciting opportunity for modernizing a... ...automated or tool-enabled, with quarterly reporting against a documented improvement roadmap. Candidates should be excited to lead change...Temporary workWorldwideFlexible hours$70.3k - $80k
...Description We are currently seeking a dynamic Performance Improvement Specialist within the Quality Department who will oversee the daily... ...outcome reporting readiness; electronic health record (EHR) documentation improvement; EHR system troubleshooting and/or vendor...Work at office- ...Description About the Role Join myPlace Health as a Clinical Documentation Integrity Specialist - Registered Nurse in Los Angeles, CA. myPlace Health... ...clinical documentation to identify opportunities for improvement and ensure compliance with coding guidelines....
- Oak Street Health is seeking a Medical Scribe to support primary care providers with real-time clinical documentation. You will observe visits, document encounters, and help close care gaps using ICD-10 and CPT coding. The role emphasizes on-the-job training in value-based...Full time
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- ...(inpatient and ambulatory surgery) abstracts clinical information from a variety of medical records charts and documents and assigns appropriate ICD-10 - CM/PCS and CPT... ...Attends meetings as required and strives to improve the quality of meetings by taking an active role...Full timeWork at officeRemote work
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- San Gabriel Valley Medical Center in California seeks a ward clerk to provide non-direct patient care and non-clinical support, maintain accurate patient records, and facilitate communication between nursing staff and other departments. The role requires basic arrhythmic...
$17 per hour
We are looking for a Document Processing Specialist to join our 1st shift team. If you have experience in document handling, sorting, and decisioning, this role offers a great opportunity to apply your skills in a structured environment. The Document Processing Specialist...Permanent employmentContract workLocal areaDay shift- BPR Consulting Group is seeking a Document Control Inspector to join our team in Alhambra, CA. This full-time, in-person role supports permit issuance and building code guidance for clients and the public. Strong customer service and clerical skills are essential, along...Full time
$34 - $39 per hour
...responsible for evaluating the accuracy and consistency of coded clinical data quality results and reports in accordance with accepted... ...including but not limited to ICD-10-CM, CPT, E&M and record documentation to ensure compliance in the collection of outpatient...Hourly payFull timeWork at officeLocal areaFlexible hoursWeekend workAfternoon shift- ...leadership skills to supervise nursing staff within SNF/LTC settings. The role requires adherence to infection control and quality improvement practices while ensuring patient care is delivered per physician orders and facility policy. Candidates must hold a California...
$23 - $30.54 per hour
...our children and their families. With 20+ hospitals, outpatient clinics, ambulatory care centers and outreach locations across the... ...opportunities while providing innovative suggestions for process improvement. Position Responsibilities Serves as the front door of...Full time$38 - $41 per hour
Utilization Clinical Reviewer - Remote | WFH job at Get It - Healthcare. Los Angeles, CA... ...appropriateness of care, ensuring that documentation complies with established standards.... ...paperwork in a timely manner. Process Improvement: Collaborate with stakeholders to identify...Remote jobHourly payFull timeWork from homeFlexible hours- ...standards. The person in the Medical Coder role will work closely with revenue cycle partners, clinical teams, and leadership to resolve coding issues, improve documentation quality, and maintain consistent coding performance. This position is a remote Monday - Friday....Remote workMonday to Friday
$33.18 - $41.31 per hour
...reviews and audits patient charts and documentation to support activities of agency. Prepares... ...with patient care staff to assure and improve the quality of the organizations services... ...trainings for administrative and clinical staff about medical record quality. Performs...Hourly payFull timeWork experience placementFlexible hours- ...ensure accuracy, privacy, and efficient data retrieval to support clinical decision-making and patient safety. Ideal candidates will have RHIT certification, familiarity with home health documentation, and strong data management and organizational skills to thrive in...Flexible hours
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