COMPANY MISSION

Duo Health is a new type of medical group designed around the needs of patients with chronic kidney disease and their physicians. Our unique Health Mobilization™ platform partners multidisciplinary care teams with community nephrologists and activates all the other clinicians, facilities, and community organizations necessary to treat the whole patient on their terms. Our team is comprised of leaders in value-based healthcare, technology, and behavioral science who share a vision for advancing health equity, one relationship at a time.
Our interprofessional care teams, which include physicians, nurses, social workers, and patient navigators, provide high-touch, comprehensive care to a small panel of patients. Team collaboration is essential to our intensive, psycho-social model of care, which includes assessment, medication management, social management, and behavioral health management.

JOB DESCRIPTION

As the Clinical Documentation Integrity Specialist, you will play a critical role in fostering a culture of best-in-class clinical documentation accuracy. This will support the development of a care model focused on quality and health outcomes. You will work closely with our Coding Specialist, Medical Group Operations, Revenue Cycle Management, and Compliance teams to leverage your coding and documentation expertise to enhance the quality, completeness, and compliance of clinical documentation. You will also serve as the subject matter expert on HCC documentation requirements and ICD-10-CM coding guidelines.

REQUIREMENTS

• 5+ years of overall CDI and quality experience, including 3+ years of outpatient risk adjustment CDI experience.
• Active RN license required.
• Ability to perform independently and drive projects and problem resolution without supervision.
• Bachelor’s degree in nursing preferred; however, an equivalent combination of education and experience may be considered.
• Certifications: CCS, CRC, CPC, CCDS, or CDIP.
• Strong knowledge of medical terminology, physiology, pharmacology, disease processes, and related procedures.
• Knowledge of risk adjustment (HCCs), guiding principles, and reimbursement methodology.
• Ability to flourish in fast-paced environments, work independently, and identify opportunities for success.
• Excellent attention to detail, data-driven approach, and tech-savviness.
• Strong written and verbal communication skills and critical thinking skills.
• Proven ability to effectively build relationships and collaborate with coworkers and clinicians in a remote setting.
• Certifications and licenses must be renewed by their expiration date to remain compliant.

• Ensure that Duo’s Burden of Illness team members and providers meet coding rules, query compliance, and company compliance guidelines.
• Perform assessments of data to identify opportunities for provider education and operational optimization.
• Conduct quality reviews in conjunction with CDI reviews to ensure that quality measures are captured accurately.
• Serve as a subject matter expert on HCC documentation requirements and ICD-10-CM coding guidelines.
• Query providers to ensure that appropriate documentation is included in the medical record while maintaining compliance in all areas.
• Develop and maintain strong professional relationships with medical providers across the organization.
• Conduct ongoing education and training for providers on proper documentation and coding.
• Assist leaders with the analysis, trending, and presentation of audit/review findings, outcomes, and issues.