Clinical Review Specialist - Remote

Overview

The Clinical Review Specialist (CRS) plays a vital role in improving the quality and accuracy of patient documentation and diagnosis coding through comprehensive chart reviews and provider education.

In Short

• Facilitates accurate identification of patient medical conditions.
• Conducts pre-visit reviews to enhance diagnosis accuracy.
• Educates providers on risk capture and documentation practices.
• Maintains clinical licensure and coding credentials.
• Identifies education and process improvement opportunities.
• Communicates with care teams to improve documentation.
• Participates in organizational programs and meetings.
• Stays updated on coding guidelines and best practices.
• Builds collaborative relationships across the enterprise.
• Handles conflict constructively and offers solutions.

Requirements

• 3-5 years of experience in case management, coding, or CDI.
• Experience in Primary Care or risk adjustment preferred.
• Current certification in Clinical Documentation Improvement preferred.
• Certification in medical coding or risk adjustment preferred.
• Medical licensure (RN, PA, NP) preferred.
• Bachelor’s degree in a healthcare-related field preferred.
• Strong PC skills and proficiency in Microsoft applications.

Benefits

• Opportunity to work with a leading healthcare organization.
• Involvement in groundbreaking medical discoveries.
• Professional development and educational opportunities.
• Supportive and collaborative work environment.
• Commitment to community service and patient care.