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