Physician Clinical Documentation Specialist

TriHealth • Cincinnati, OH

4d • Remote

About The Position

At TriHealth, our Physician Clinical Documentation Specialists play a vital role
in ensuring that clinical documentation accurately reflects patient complexity,
risk, and the care our providers deliver. In this role, you’ll partner closely
with physicians to strengthen documentation through pre‑visit HCC reviews or
post‑claim E/M assessments, helping support accurate coding, compliant billing,
and meaningful provider education. Your expertise directly contributes to
TriHealth’s commitment to high‑quality, data‑driven, patient‑centered care.

We’re looking for candidates with strong clinical knowledge, critical thinking
skills, and experience in coding or clinical practices supported by credentials
such as CCS, CPC, CRCR, or nursing licensure. At TriHealth, you’ll join a
collaborative, mission‑driven team where your analytical skills, communication
strengths, and documentation insight make a measurable impact on both provider
performance and patient outcomes.

Apply today and grow your career with a team that truly values you.

Requirements

• Associate’s degree OR RN/LPN licensure OR coding certification with five years experience in ambulatory coding. (Required)
• Extensive clinical knowledge and understanding of anatomy and pathophysiology
• Strong critical thinking skills and utilization of clinical knowledge to identify potential clinical indicators supporting patient complexity and clarifications of the medical record
• Strong problem solving and investigative skills
• Excellent written and verbal communication skills, including effective presentation skills
• Demonstrates skilled ability and comfort with electronic medical records (EPIC preferred)
• Proficient with personal computer applications (Excel, Word, and Power Point)
• CCS - Certified Coding Specialist Required or CPC - Certified Professional Coder Required or Certified Revenue Cycle Rep (CRCR) Required or Other Coding Credential Required and Registered Nurse Preferred or Licensed Practical Nurse Preferred

Nice To Haves

• 3 - 4 years of experience in a related field (Preferred)
• Registered Nurse Preferred or Licensed Practical Nurse Preferred

Responsibilities

• Conducts pre visit chart reviews to identify documentation gaps, chronic conditions, and suspect conditions, and prepare concise summaries with supporting evidence for providers.
• Performs post claim E/M reviews to evaluate medical decision making, patient complexity, and documentation accuracy, identifying opportunities for improved code assignment and HCC capture.
• Analyzes clinical documentation - including problem lists, historical notes, labs, medications, and specialist reports - to identify missing clinical indicators or descriptors needed to support diagnoses and billed levels of service.
• Communicates effectively with providers, offering clarification when needed and providing compliant suggested documentation language to improve accuracy and completeness.
• Delivers targeted provider education, including specialty specific tips, ongoing feedback, and sessions based on trends, chart review findings, and data analytics.
• Collaborates with Professional Fee CDI leadership and cross functional teams, using performance and outcome data to identify high priority providers and supporting accurate reporting to coding/risk teams.
• Maintains professional knowledge and standards, ensuring adherence to CMS and industry guidelines, staying current with HCC and E/M requirements, and upholding HIPAA confidentiality.

Benefits

• TriHealth offers a comprehensive benefits package which includes medical, dental, vision, paid time off, retirement plans, and tuition reimbursement.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 1,001-5,000 employees