CDI Specialist

Job Duties & Skills Required

The overall purpose of this job utilizes advanced clinical coding expertise to direct efforts towards the integrity of clinical documentation through the roles of review, educator, and consultant. Facilitates the overall quality, completeness, accuracy, severity of illness, and integrity of medical record documentation to support correct coding and reimbursement. This role bridges clinical care and administrative processes, focusing on improving recapture rates and compliance with CMS-HCC risk adjustment models. Supports and lives out Immanuel’s Mission and CHRIST Promises.

Key Responsibilities

• Concurrent review of participant medical records to identify incomplete, inaccurate, or inconsistent clinical information.
• Initiate and manage compliant, non-leading queries to providers to clarify documentation and ensure clinical accuracy.
• Collaborate with external medical coding company to ensure that clinical documentation supports the assignment of appropriate diagnosis and procedure codes.
• Collaborate and provide ongoing education and training with providers and interdisciplinary team members to clarify documentation and improve coding accuracy and the importance of complete, accurate chart documentation to support reimbursement.
• Analyze clinical data to identify documentation trends, measure the impact of improvement initiatives, and report findings to leadership.
• Serve as a subject matter expert and liaison between clinical, coding, and quality departments to resolve documentation discrepancies.
• Develop provider education curriculum relating to risk adjustment coding and documentation best practices, research and update internal coding compliance and policies in accordance with CMS-HCC (v22/V28) guidelines and ICD-10-CM/CPT II coding standards.
• Develop coding tips, newsletter articles, and clinical documentation initiatives to ensure diagnoses are documented with the specificity and detail required for Hierarchical Condition Categories (HCC).

Qualifications

• Education- Bachelor of Science in Nursing preferred. Experience- Three (3) years of experience coding ICD-10 CM and experience in ICD-10 CM in a risk adjustment environment. Equivalent years of education may substitute for experience requirement. Five (5) years of clinical experience preferred.
• Must possess valid medical coding certification in one of the following areas: Certified Clinical Documentation Specialist (CCDC), Certified Risk Adjustment Coder (CRC), Certified Coding Specialist designation (CCS), Certified Professional Coder (CPC).

Benefits

Best in Class Benefits can be found at Immanuel:HEALTH: Medical, dental, vision, Health Savings Account (HSA), and Flexible Spending Account (FSA)
LIFE INSURANCE: Employer Paid Life Insurance
TIME OFF: Paid Time Off - accruing from day one of employment, Floating Holidays, Paid Holidays, 8 hours of Volunteer Time Off per year
RETIREMENT: 401K with employer match
WELLNESS: Wellness Program and Employee Assistance Program
GROWTH AND DEVELOPMENT: Advancement opportunities (as appropriate) – we look to grow from within our organization, Education Assistance Program – we invest up to $5,250 per year for education assistance paid up front
Plus many more benefits!