BHMG Ambulatory CDI Specialist

The BHMG Ambulatory CDI Specialist I is responsible for the evaluation of documentation utilizing their coding and clinical expertise to ensure specificity of coding and coding accuracy. They identify HCC diagnosis codes, ensure documentation accurately reflects the medical necessity and acuity of the patients. They provide guidance/education to the providers, medical assistants, practice managers and ancillary staff on clinical documentation best practices.  Position requires a self-motivated, flexible, confident presenter that is able to travel and work remotely as well as attend internal meetings.

Minimum Education, Training, and Experience Required

• 2 years’ professional medical group coding experience

• Experience with:

  • ICD-10-CM coding principles and procedures,

  • HCPCS, CPT, CPT II and modifier coding,

  • CMS HCC, HHS HCC, Rx HCC coding and risk adjustment assignment as it relates to provider documentation,

  • Knowledge of Microsoft Office (Outlook, PowerPoint, Excel)

• Preferred Experience

  • HCC (CMS, HHS, Rx HCC) coding and risk adjustment assignment as it relates to provider documentation,

  • Proficient experience with Epic and/or other major EMR vendor software, and

  • Presenting education to coders, providers and/or other caregivers.

  • Clinical experience a plus

Certification/Licenses:

• Active Certification Required:

  • Certified Professional Coder (CPC)

    certification or Certified Coding Specialist-Physician based (CCS-P) or equivalent

    certification from AAPC, AHIMA or other

    acceptable professional organization.

• A minimum of one additional advanced certification, required within one year of hire.

  • CRC = Certified Risk Adjustment Coder (certification)