Outpatient Clinical Documentation Improvement, CDI Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Act as a subject matter expert in the domains of clinical documentation quality, risk adjustment, and HCC coding integrity within the outpatient environment.

• Conduct prospective reviews of medical records from physician practices, outpatient facilities, and pertinent inpatient encounters.

• Verify chronic conditions and guarantee the accuracy of documentation, clinical integrity, appropriate coding, and HCC capture.

• Utilize Epic and OurPractice Advisories (OPAs) to execute prospective chart reviews and pinpoint documentation enhancement opportunities.

• Monitor and manage work queues, review inventories, and activities related to OPAs.

• Ensure timely follow-ups, meet productivity goals, and accurately complete CDI interventions.

• Oversee, analyze, and report on CDI outcomes, documentation trends, and the performance of HCC recapture.

• Recognize areas for improvement and assist in achieving program objectives.

⛳️ Requirements

• At least 2 years of experience in ambulatory Clinical Documentation Integrity, Risk Adjustment, or related healthcare documentation.

• An active LPN or RN license is mandatory.

• CCDS, CCDS-O, CDIP, CDEO, and/or CRC certification is highly preferred.

• Familiarity with Epic workflows, including the interpretation and management of OurPractice Advisories (OPAs), is preferred.

• Comprehensive understanding of ICD-10-CM coding guidelines and HCC documentation and coding requirements.

• Strong grasp of clinical criteria for HCC diagnoses.

• Exceptional communication, critical thinking, and organizational abilities.

• Proficient in using MS Office, email, VPNs, virtual machines, two-factor authentication, and video conferencing tools (such as MS Teams, Zoom, etc.).

🏝️ Benefits

• Comprehensive benefits package.

• Paid Time Off (PTO).

• Competitive salary.

• A collaborative, mission-driven team atmosphere.

• Opportunities for ongoing learning, education, and professional advancement.

• Leadership that appreciates and values your expertise and feedback.