Clinical Doc Improvement Specialist | Remote | Maine Residence

Clinical Doc Improvement Specialist | Remote | Maine Residence Required | Full-Time

Job Category
:
Clinical

Requisition Number
: CLINI
004599

• Posted:
  February 25, 2026
• Full-Time

Showing 1 location

South Portland, ME 04106, USA

CORE RESPONSIBILITIES:

• Conducts prospective and retrospective review of the medical record to ensure accurate, complete, and specific documentation that reflects the current clinical complexity of the patient
• Collaborates with Coding and Coding Education Staff to:
  • Provide education to Providers and support clinical care teams on documentation, coding changes, and compliance concerns
  • Monitor changes in laws, regulations, rules, and code assignments that impact documentation, reimbursement, and patient risk scores
  • Provide input and valuable feedback on audit results as applicable
• Collaborates with interdisciplinary teams to assist with problem resolution, appropriate reimbursement, and systems/performance measures
• Provides consultation and education to organizational departments and committees as requested to ensure regulatory compliance and optimum reimbursement
• Develops relationships with providers and communicates guidelines and requirements of Risk Adjustment Payment System to ensure accurate coding and documentation
• Maintains knowledge of related regulations and requirements supporting ACA/Commercial Risk Adjustment Data Validation
• Completes and tracks all Patient Assessment Forms and other various projects as requested by health plans
• Maintains strict confidentiality in alignment with HIPAA (Health Insurance Portability and Accountability) guidelines and Inter Med policies.
• Perform other duties to support the mission, vision and values of Inter Med.

MISSION AND VALUES:

• Follows Inter Med’s mission to provide patient-centered primary care, putting the patient first to deliver high quality, high value care.
• Provide the highest quality care to our patients with a level of service that exceeds their expectations.
• Maintain a positive attitude and always treat our patients and each other with dignity and respect.
• Insist on honesty and integrity from each other and our business partners.
• Make teamwork a core component of our relationships between physicians, staff, and patients.
• Embrace change to better serve our patients.
• Use business practices that feature individual accountability and group responsibility to ensure delivery of high value healthcare.
• Have fun as we carry out our mission to serve.

KNOWLEDGE, SKILLS, AND ABILITIES:

• Education:
• Associate’s degree in nursing or higher required;
  Bachelor’s degree in Nursing preferred
• Experience:
  • Recent clinical experience (minimum 5 years), preferably in primary care setting
  • Experience with EMR, preferably eClinical Works
  • 1+ years of recent experience in ICD-10 coding or Risk Adjustment/HCC coding (preferred)
  • Familiarity with HEDIS measures, abstraction processes, Medicare Risk Adjustment, CMS guidelines, and health plan terminology (preferred)
  • Proficiency in Microsoft Office (Word, Excel, Outlook, PowerPoint)
  • Strong attention to detail with excellent organizational and time-management skills
  • Ability to manage multiple priorities and meet deadlines with accuracy
  • Flexible and adaptable; able to work independently and collaboratively in a team environment
  • Clear and professional written and verbal communication skills
  • Sound judgment, decision-making ability, and professional discretion
  • Strong problem-solving skills with the ability to think critically and apply deductive reasoning
• License/
  
  Certifications:
  • Active and unencumbered Registered Nurse licensure in the State of Maine
  • Certified Risk Adjustment Coder (CRC) or ability to obtain certification within 6 months from date of hire

RN License

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.