UCLA Health

Clinical Documentation Integrity Specialist

UCLA Health$100K — $218K *
Hospitals & Medical Centers
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 5-7 years of experience in clinical documentation and denial management
  • Strong understanding of medical coding and compliance regulations
  • Proven ability to analyze and interpret clinical data
  • Excellent communication skills for educating healthcare professionals
  • Experience in writing appeal letters and documentation strategies

Responsibilities

  • Review high-acuity patient records to identify payer denials
  • Assess clinical validity and support denial prevention
  • Communicate continuously with department staff and physicians
  • Gather and analyze information for accurate medical record documentation
  • Prepare and submit high-quality appeal letters with supporting evidence
  • Identify denial trends and provide feedback to clinical teams

Benefits

  • Access to ongoing professional development and training
  • Supportive team environment within a high-performing unit
  • Collaboration with diverse healthcare professionals
  • Opportunity to impact patient care through documentation integrity
  • Flexible working arrangements to promote work-life balance
Full Job Description
You will become a member of our highly successful Clinical Documentation Integrity and Denial Management team, including all modalities. This role involves daily review of high-acuity patient records to identify potential and active payer denials, assess clinical validity, and to support denial prevention, analysis, and appeals across inpatient and outpatient settings; continuously communicating with department staff; educating physicians, residents, and mid-levels; and assisting with appropriate documentation strategies. Partnering with Medical Coding, Clinical Documentation Integrity, Case Management, and the Quality team, you will gather/analyze information to provide comprehensive medical record documentation that accurately reflects clinical treatment, decisions, and diagnoses. Leveraging your denial management experience, clinical expertise, and coding knowledge to identify opportunities and ensure accuracy and completeness of clinical documentation for denial prevention. You will prepare and submit high quality appeal letters supported by clinical evidence, regulatory guidelines, and payor-specific medical necessity criteria, while identifying denial trends and root causes and provide feedback to the CDI and Clinical teams. Salary Range: $100,161.36 - $218,718.00/year

About UCLA Health

UCLA Health is a world-renowned academic medical center located in Los Angeles, California. It comprises four hospitals, including Ronald Reagan UCLA Medical Center, and more than 200 primary and specialty care clinics. UCLA Health is affiliated with the David Geffen School of Medicine at UCLA and is consistently ranked among the top hospitals in the United States. The health system employs over 20,000 people and serves as a major center for patient care, medical education, and research.
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