Remote Clinical Documentation Integrity Specialist (Bilingual in Spanish/En at Duo Health

San Juan, , Puerto Rico -

Full Time

Start Date

Immediate

Expiry Date

12 Oct, 26

Salary

0.0

Posted On

14 Jul, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Clinical Documentation Integrity, ICD-10-CM Coding, HCC Risk Adjustment, Bilingual Spanish-English, Medical Record Review, Provider Education, Outpatient Risk Adjustment, Clinical Auditing, Medical Terminology, Pharmacology, Project Management, Analytical Thinking

Industry

Medical Practices

Description

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 own terms. Our team is comprised of leaders in value-based health care, 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 and 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. Duo Health is dedicated to ensuring our staff reflects the diversity of our patient population and applicants whose work demonstrates a commitment to issues of diversity are encouraged to apply. Job Description The Clinical Documentation Integrity (CDI) Specialist plays a critical role in supporting Duo Health's value-based care model by promoting accurate, complete, and compliant clinical documentation. Working closely with Coding, Medical Group Operations, Revenue Cycle Management, and Compliance teams, this individual serves as the subject matter expert on HCC documentation requirements, ICD-10-CM coding guidelines, and outpatient risk adjustment documentation. This position supports both English and Spanish-speaking providers and care teams. The ideal candidate is fully bilingual in Spanish and English and is able to review Spanish-language medical documentation, communicate effectively with providers in both languages, and ensure accurate, compliant translation of clinical concepts into coding practices. Location: 100% Remote Work Hours: Monday–Friday, 8:00 am–5:00 pm Duties and Responsibilities * Review clinical documentation to ensure accurate, complete, and compliant coding in accordance with ICD-10-CM, HCC, and regulatory guidelines. * Serve as the subject matter expert on outpatient risk adjustment documentation and HCC coding requirements. * Conduct Clinical Documentation Integrity (CDI) reviews and Quality reviews to ensure accurate capture of quality measures and risk adjustment data. * Query providers for documentation clarification while maintaining compliance with coding and documentation standards. * Analyze documentation trends and identify opportunities for provider education, workflow improvements, and operational optimization. * Develop and deliver ongoing education and training to providers on documentation best practices and coding requirements. * Build strong collaborative relationships with providers and cross-functional teams across the organization. * Assist leadership with analysis, trending, reporting, and presentation of audit findings and documentation improvement opportunities. * Review and interpret Spanish-language medical records to ensure accurate ICD-10 and CPT coding. * Communicate effectively in both Spanish and English with providers and care team members regarding documentation questions and coding guidance. * Identify documentation trends within Spanish-language records and communicate findings to stakeholders to improve coding accuracy and risk capture. * Support bilingual care teams by translating or clarifying documentation-related concepts while maintaining compliance standards. * Provide documentation guidance to Spanish-speaking frontline Care Navigators as needed. * Assist with translating documentation education and training materials for Spanish-speaking providers and care teams. * Maintain confidentiality of patient information and adhere to all company policies and compliance requirements. * Support Duo Health's continuous quality improvement initiatives. Requirements * Minimum of 5 years of Clinical Documentation Integrity (CDI) and Quality experience. * Minimum of 3 years of outpatient risk adjustment CDI experience. * Fluency in both spoken and written Spanish and English is required. * Ability to read, interpret, and analyze clinical documentation written in Spanish. * Ability to communicate effectively with clinicians and internal teams in both English and Spanish. * Strong knowledge of ICD-10-CM coding, HCC risk adjustment methodology, medical terminology, disease processes, pharmacology, and clinical documentation standards. * Experience independently managing projects and driving documentation improvement initiatives. * Bachelor's degree in nursing preferred; equivalent education and experience will be considered. * CCS, CRC, CPC, CCDS, or CDIP certification preferred. * Strong analytical, organizational, and critical thinking skills with exceptional attention to detail. * Comfortable working independently in a fast-paced, remote environment. * Excellent written and verbal communication skills. * Ability to build strong working relationships and collaborate effectively in a virtual environment. * All required certifications and credentials must remain active and current. Working for Duo * 100% remote working environment * Competitive medical, dental, and vision plans * Paid maternity and paternity leave * Adoption Assistance * Access to free wellness & personal development courses * 401(k) plan with company matching * 12 Paid holidays * A mission-driven approach to everything we do, with an overall goal of improving health equity and health outcomes.

Responsibilities

The specialist ensures accurate and compliant clinical documentation by reviewing records and querying providers according to ICD-10-CM and HCC guidelines. They provide bilingual support and education to English and Spanish-speaking care teams to optimize risk capture and quality measures.