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Clinical Documentation Improvement Specialist - Bronx / Manhattan, NY

UnitedHealth Group

Bronx, NY
Job Code:
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Job Details

Clinical Documentation Improvement Specialist - Bronx / Manhattan, NY(Job Number:728709)

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

The Clinical Documentation Improvement Specialist (CDIS) conducts medical record documentation and coding quality reviews to ensure correct coding and documentation of encounter data for Risk Adjustment and Fee for Service product lines. The CDIS also recommends processes for accurate coding and documentation practices through communication and education with their assigned provider teams to ensure compliance with federal regulations, statutes, and the Office of Inspector General.


***This position will be traveling to 2 boroughs - Bronx and Manhattan.  Office is based at W 34th Street in Manhattan and traveling to skilled nursing facilities in both Manhattan and Bronx.***


Primary Responsibilities:

  • Performs onsite concurrent coding quality reviews for provider charts as well as other teams as needed

  • Evaluates documentation to ensure that diagnosis coding is supported and meets specificity requirements for accurate submissions

  • Queries providers regarding missing, unclear, or conflicting health record documentation by requesting and obtaining additional documentation within the heath record

  • Provides coaching and feedback and develops targeted education and training to provider teams to improve accuracy

  • Provide ICD10-CM coding training, as it relates to HCC coding, as requested

  • Develops relationships with clinicians and communicates guidelines and requirements of Risk Adjustment Payment System to ensure correct coding and documentation

  • Develops relationships with clinical providers and communicates coding and documentation guidelines and requirements of the Risk Adjustment program to ensure correct coding and documentation

  • Maintains a 95% quality audit accuracy rate

  • Takes direction and guidance from Supervisor of the Risk Adjustment Coding and Documentation Improvement Specialist and the Manager of the Risk Adjustment Coding and Documentation Improvement Program


Job Quality Management
Primary Location US-NY-Bronx
Other Location US-NY-Manhattan
Organization Local Care Delivery Shared Svc
Schedule Full-time
Number of Openings 1
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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