Clinical Documentation Reviewer

Clinical Documentation Reviewer (Physician)

Location: Remote

Contract

Northern California business hours (8:00 AM – 5:00 PM PST)

Job Description:

Client is seeking non-practicing physicians to support their Clinical Documentation – Diagnosis Value initiative.

Preferred qualifications include:

• Medical degree (foreign-trained or U.S.-trained physicians are both acceptable). Approximately 99% of their current team consists of foreign-trained physicians.
• Strong clinical foundation with the ability to quickly learn new processes.
• Excellent written and verbal communication skills.
• Experience with:
• Medical risk adjustment
• HCC (Hierarchical Condition Categories)
• Clinical documentation
• Medical terminology
• Risk adjustment experience is highly preferred.
• CDI experience is a plus but is not required.
• This team supports an outpatient patient population, so candidates with outpatient clinical experience are preferred, although an outpatient background is not required.
• ECFMG certification is required or highly preferred for foreign-trained physicians.

Role Responsibilities

• Review individual patient cases using client's online review tool.
• Open patient records and evaluate documented diagnoses.
• Determine whether each diagnosis is clinically supported ("Yes" or "No").
• Submit written documentation/prompts to the Kaiser medical team for follow-up and review.

Client will provide training on their internal processes, but candidates should be able to work independently, learn quickly, perform their own research when needed, and have a strong baseline of clinical knowledge. They emphasized that they are looking for high-quality candidates.