Offer summary

Qualifications:

5+ years of overall experience in clinical documentation or related fields., 3+ years of specific experience in Clinical Documentation Integrity (CDI)., 2+ years of outpatient HCC coding experience, with knowledge of Medicaid documentation requirements being a plus., CPC, CCS or equivalent certification, along with proficiency in medical terminology and coding guidelines..

Key responsibilities:

Review upcoming visits to validate chronic conditions and identify potential suspect conditions for provider assessment.

Utilize various systems to find clinical support for closing risk adjustment gaps.

Ensure compliance with documentation rules and coding guidelines while performing data assessments to improve operations.

Develop strong professional relationships with medical providers and serve as a subject matter expert on HCC documentation requirements.

Job description

Job Description:

About the Role:

The Clinical Documentation Improvement (CDI) Specialist will play a critical role in creating a culture of best-in-class clinical documentation accuracy in support of building a model of care focused on quality and health outcomes. The role will require working closely with our Burden of Illness, Clinical, and Compliance teams to participate in our Clinical Documentation Integrity program and leverage your clinical, coding, and documentation expertise to foster improvements in the overall quality, completeness, and compliance of clinical documentation.

Responsibilities:

Reviews upcoming visits to validate persistent (chronic) conditions and raise potential suspect conditions for provider to assess
Utilizes various systems to find clinical support to assist in closing risk adjustment gaps
Responsible for ensuring documentation rules, coding guidelines and company compliance guidelines are met
Performs assessments of data to improve overall operations and identify opportunities for provider education and optimization
Serves as a subject matter expert on Hierarchical Condition Category (HCC) documentation requirements and International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding guidelines
Develops and supports strong professional relationships with medical providers across the organization

Requirements for the Role:

5+ years of overall experience;
3+ years of Clinical Documentation Integrity (CDI) specific experience.
2+ years of outpatient HCC coding experience
Medicaid documentation requirements understanding is a plus
CPC, CCS or equivalent certification
Knowledge of medical terminology, physiology, pharmacology, and disease processes and related procedures. Knowledge of risk adjustment (HCCs), guiding principles, and reimbursement methodology
Proficiency with Google Suite and Microsoft Office, experience navigating EHR’s and various systems to complete assigned tasks

We take into account an individual’s qualifications, skillset, and experience in determining final salary. This role is eligible for health insurance, life insurance, retirement benefits, participation in the company’s equity program, paid time off, including vacation and sick leave. The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location. The expected salary range for this position is:

$72,891 - $89,089 Annually

Cityblock values diversity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means.

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