UnitedHealth Group

Clinical Documentation Integrity (CDI) Specialist

UnitedHealth Group$72K — $130K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Undergraduate degree or equivalent experience.
  • 5+ years acute care hospital clinical RN experience OR Medical Graduate with CDI experience.
  • Advanced proficiency in clinical medicine, pathophysiology, and pharmacology.
  • Advanced proficiency communicating and working closely with Physicians.
  • Intermediate proficiency using a PC in a Windows environment, including Microsoft Word, Excel, PowerPoint, and Electronic Medical Records.

Responsibilities

  • Perform concurrent and retrospective chart reviews for improving clinical documentation completeness.
  • Stay updated on coding trends and Medicare rules regarding diagnosis coding and CDI.
  • Utilize ICD-10 materials to investigate coding issues and ensure accuracy.
  • Conduct daily follow-up with providers to clarify needed documentation specificity.
  • Provide expert leadership in clinical documentation improvement through review and recommendations.
  • Communicate effectively with providers to clarify documentation requirements based on diagnosis severity.
  • Ensure thorough follow-through on all clarification requests and improvements.

Benefits

  • Comprehensive benefits package including health care, retirement plans, and stock purchase options.
  • Incentive and recognition programs that reward performance.
  • Opportunities for professional development and career advancement
  • Dynamic work environment focused on growth and success.
Full Job Description
This position follows a hybrid schedule with four in-office days per week.

Primary Responsibilities:

  • Perform concurrent and retrospective chart reviews for improving the overall completeness of clinical documentation
  • Keep abreast of current coding trends and maintains up to date knowledge of Medicare rules and regulations regarding diagnosis coding and CDI trends
  • Effectively utilizes ICD-10 and related materials to investigate coding issues and produce accurate results
  • Conducts daily follow-up communication with providers regarding existing clarifications to obtain needed documentation specificity
  • Provides expert level leadership for overall improvement in clinical documentation by providing proficient review and assessment, and effectively articulating recommendations for improvement including the rationale for the recommendations
  • Actively communicates with providers at all levels, to clarify information and to communicate documentation requirements for appropriate diagnoses based on severity of illness and risk of mortality
  • Provides complete follow through on all requests for clarification or recommendations for improvement
  • Ensures effective utilization of Technology to document all clarification activity
  • Collaborates closely with interfacing departments such as Care Coordination and Quality.
  • Utilizes only the Optum/client approved clarification forms
  • Proactively develops a reciprocal relationship with the HIM Coding Professionals
  • Engages and consults with Physician Advisor/CMO when needed, per the hospital defined escalation process, to resolve provider issues regarding answering clarifications and participation in the clinical documentation integrity process


You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • Undergraduate degree or equivalent experience.
  • 5+ years acute care hospital clinical RN experience OR Medical Graduate with CDI experience
  • Advanced proficiency in clinical medicine, pathophysiology, and pharmacology
  • Advanced proficiency communicating & working closely with Physicians
  • Intermediate proficiency using a PC in a Windows environment, including Microsoft Word, Excel, Power Point and Electronic Medical Records


Preferred Qualifications:

  • Experience interacting with Providers providing concurrent/chart review
  • Proven comfortable with technology


Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

About UnitedHealth Group

UnitedHealth Group is a medical facility. They offer health technology, health finance, and pharmacy services. They are utilizing clinical data and intelligence to assist in the redesign, automation, and deployment of technology to streamline administrative operations and clinical decision-making. Payment systems for both consumers and providers are critical components of a health-care system.

UnitedHealth Group Careers

Joining UnitedHealth Group means becoming part of a diverse team dedicated to making a difference. As a leader in health services and innovation, our company offers a variety of job opportunities that allow professionals to leverage their skills, drive innovation, and improve lives. Work You’ll Do At UnitedHealth Group, you’ll contribute to a mission-focused environment where your expertise will influence the health and well-being of people worldwide. Our employment opportunities span across a wide range of disciplines, from healthcare specialists to data analysts, ensuring that your career journey is both dynamic and rewarding. Transform Healthcare with Your Expertise UnitedHealth Group stands at the forefront of health innovation. Our team collaborates to deliver solutions that lead to better patient outcomes. Working with us, you’ll find yourself at the intersection of technology, healthcare, and leadership, providing key insights that drive industry transformation. Join Our Global Team As part of our team, you’ll engage with over 300,000 professionals globally, dedicated to building a diverse and inclusive workplace. UnitedHealth Group is not just a company; it’s a community where you can grow your career through continuous learning and leadership opportunities. Our commitment to diversity training ensures that every team member can thrive. UnitedHealth Group Career Development We are committed to your professional growth. Explore career paths filled with promising job opportunities and internships that will harness your potential and expand your capabilities. Whether you’re a seasoned professional or a recent graduate, you’ll find that our career development programs support your ambition at every level. Innovative Work Environment At UnitedHealth Group, innovation is at the core of our operations. We encourage our team to bring forward-thinking ideas that challenge the status quo and lead to breakthrough improvements in patient care. Be Part of a Great Team Our culture fosters a collaborative and supportive environment where every member’s contribution is valued. Enjoy the benefits of being part of a global team that’s committed to making a difference in people’s lives. Future-Proof Your Career With UnitedHealth Group, your career is future-proof. Dive into a range of positions that offer both challenges and rewards. Our robust support system includes unmatched training, development programs, and certification support to propel your career forward. Stay Connected Join Our Team Discover the right position that matches your skills and interests. We are always hiring and look for passionate, curious, and solution-driven team players. Search UnitedHealth Group jobs today and take the first step towards a fulfilling career. Keep Up to Date Stay informed with career tips, insider perspectives, and industry-leading insights you can use today—all from the people who work here. Read Careers Blog Job Alert Emails Customize your subscription to receive job alerts, the latest news, and insider tips tailored to your preferences. Explore the exciting and rewarding opportunities that await at UnitedHealth Group.
Learn more about UnitedHealth Group
Size
350,000 employees
Market Cap
$493.1 billion
Industry
Net Income
$15.4 billion
Founded
1974
5 Year Trend
+9.2%
Revenue
$257.1 billion
NASDAQ

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