Job Description

Clinical Documentation Improvement Specialist Apply locations Cerritos, CA Time type Full time Posted on Posted 21 Days Ago Job requisition id M101057 Job Description Summary Responsible for conducting retrospective medical reviews to assess medical record documentation and monitoring submitted codes on claim/encounters for Medicare Risk Adjustment. How will you make an impact & Requirements Location: Candidate must reside in Los Angeles, Los Angeles County, or Orange County. This is a hybrid role with the need to travel to multiple locations 2 days per week, while working from home 3 days per week. Primary duties include, but are not limited to: Conduct retrospective medical record and claims review to assess documentation practices and accuracy of policies and procedures. Verify accuracy and appropriateness of submitted diagnosis codes based on medical record documentation, ensuring details are captured and reported accurately. Identify and recommend coding best practices to address unsupported additions/deletions and discrepancies. Update and develop policies, procedures, and training to reflect best practices. Conduct ongoing review, monitoring, and communication to promote adherence to protocols and best practices. Review documentation of well visits and routine/preventive visits, including appropriate modifiers for HEDIS scoring. Continuously review medical records to validate improvements, identify opportunities for better record-keeping, and ensure coding accuracy and compliance. Requirements Minimum of 2 years experience coding all types of medical records, including Medicare Risk Adjustment, in a physician or large group practice setting. Current Certified Professional Coder certification (CPC, CPC-H, CCS, or CCS-P) required. Additional procedural clinical coding experience preferred. Clinical background (e.g., RN, LPN, foreign medical graduates) preferred. Compensation: $90,160 - $112,700 & bonus eligibility About Us Mosaic Health: Who we are Mosaic Health is a national care delivery platform expanding access to comprehensive primary care across various health plans, serving nearly one million consumers in 19 states. We provide high-quality primary care, integrated teams, digital access, and specialized services, aiming to improve health and wellbeing. For more information, visit . Mosaic Health is an Equal Employment Opportunity employer. All qualified applicants will receive consideration regardless of age, citizenship, color, creed, disability, ethnicity, genetic information, gender, marital status, national origin, race, religion, sex, sexual orientation, veteran status, or other protected status. If you require accommodations during the application or interview process, contact recruiting@apree.health for assistance. #J-18808-Ljbffr Carelon Management Services LLC

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