Clinical Documentation Improvement Lead

ESSENTIAL FUNCTIONS
Lead clinical documentation improvement initiatives focused on orthopedic and musculoskeletal specialties
Review provider documentation for completeness specificity medical necessity and coding accuracy
Partner with physicians APPs coding teams and operational leaders to improve documentation workflows and reduce
revenue leakage
Identify trends impacting reimbursement denials downcoding charge lag and documentation deficiencies
Provide education and real-time feedback to providers regarding coding documentation standards payer requirements
and compliance expectations
Serve as a subject matter expert for Athena documentation workflows claim edits charge capture and operational
reporting
Collaborate with coding and denial management teams to resolve documentation-related reimbursement issues
Support audit readiness and compliance initiatives through routine chart reviews and documentation monitoring
Assist in the development and maintenance of documentation policies workflows tip sheets and provider education
materials
Analyze documentation and coding trends to support operational performance improvement and financial optimization
Monitor payer policy changes and regulatory updates impacting MSK documentation and reimbursement
Participate in cross-functional operational meetings and revenue cycle performance initiatives
EDUCATION
Certified Professional Coder (CPC) CCS RHIA RHIT or equivalent coding certification required
EXPERIENCE
Minimum 5 years of clinical documentation improvement coding or revenue cycle experience in orthopedic/MSK specialties required
Strong working knowledge of musculoskeletal and orthopedic procedural and diagnosis coding