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Clinical Documentation Integrity Specialist
Location
United States
Posted
61 days ago
Salary
0
Seniority
Mid Level
Job Description
Clinical Documentation Integrity Specialist
CorroHealth
Role Description The Outpatient Clinical Documentation Integrity (CDI) Specialist supports accurate, complete, and compliant provider documentation in ambulatory settings. This role focuses on chronic condition capture, risk adjustment accuracy, quality reporting, and provider education to ensure documentation reflects the true clinical complexity of the patient population. Essential Duties and Responsibilities - Review outpatient encounters (pre visit, concurrent, and/or post visit) to assess documentation accuracy and completeness. - Identify opportunities for improved documentation related to: - Chronic conditions and disease specificity - Risk adjustment (e.g., HCCs) - Quality measures and medical necessity - Provide compliant documentation clarification via query and feedback to providers through approved communication channels. - Support accurate problem list management and ongoing condition validation. - Collaborate with coding, quality, compliance, and revenue cycle teams as needed. - Track and report CDI interventions, trends, and outcomes. - Participate in provider education and training initiatives. - Stay current on outpatient coding, risk adjustment, and regulatory guidance. Compliance & Regulatory Oversight - Ensure compliance with CMS, payer, and organizational documentation and billing requirements. - Identify potential compliance risks, including but not limited to overcoding, undercoding, and missing and/or unsupported diagnoses. - Apply knowledge of HCCs, risk adjustment, quality measures, and outpatient reimbursement methodologies as applicable. Qualifications - An active coding credential required such as - RHIA, RHIT, CPC, COC, CCS-O, CCS, CDEO, CCDS, CDIP or CCDS-O. - 3+ years of outpatient coding, risk adjustment, outpatient CDI. - Strong understanding of: - ICD‑10‑CM outpatient coding - Risk adjustment models (e.g., Medicare Advantage HCCs) - Outpatient E/M documentation requirements - Experience working in an ambulatory EHR (Epic, Cerner, or similar). Skills & Competencies - Strong clinical and analytical judgment. - Professional communication style. - Excellent written documentation skills. - Comfortable working independently in a fast-paced environment. - Proficient in Microsoft Office Applications. Physical Demands - Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. - Regular eye-hand coordination and manual dexterity is required to operate office equipment. - The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. - At times, Team Members are subject to sitting for prolonged periods. - Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. - Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
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