Clinical Denials Specialist

3 days ago


Roseville, California, United States Adventist Health Full time
Job Title: Clinical Denials Specialist

Adventist Health is seeking a highly skilled Clinical Denials Specialist to join our team. As a Clinical Denials Specialist, you will play a critical role in ensuring the accuracy and completeness of clinical documentation in patient medical records.

Key Responsibilities:
  • Evaluate and assess medical records to ensure specificity of illness, accuracy of clinician's documentation, and compliance with coding requirements.
  • Analyze and interpret medical records and clinical documentation to formulate appropriate physician queries.
  • Communicate with physicians and coding staff to ensure clinical information in medical records is present and accurate.
  • Stay up-to-date with regulatory changes related to documentation and coding.
Requirements:
  • Associate's/Technical Degree or equivalent combination of education/related experience.
  • Three years' clinical experience.
  • Two years' clinical documentation experience.
  • Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Practitioner Certificate (DIP).
About Us:

Adventist Health is a faith-based, nonprofit, integrated health system serving over 90 communities on the West Coast and Hawaii. We are committed to the safety and well-being of our associates and patients.



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