Outpatient CDI Specialist-Hybrid

Responsibilities

This position requires the ability to build strong working relationships with Clinicians, Administrators, and Revenue Cycle colleagues. This position must possess strong communication skills to bridge and connect interrelated concepts, business functions, and processes in order to deliver results through an Outpatient CDI program. Not only will this position need to understand various payment structures, fee schedules, and reimbursement methodologies in the outpatient setting and with physician encounters, but requires knowledge of how physician documentation translates into ICD-10-CM and HCPCS/CPT codes for claims submission to meet reporting requirements. This position will be expected to create and effectively deliver presentations educating physicians, group practices and administration as well as individually track, monitor, and report on case reviews and document results achieved. This position requires skills of prioritization and organization of time and materials, which may include addressing physician documentation and education needs, demanding and competing priorities and deadlines. This position will be recognized and relied upon as a subject matter expert in how proper provider documentation drives accurate coding of outpatient services.

Qualifications

• Requires a minimum of an Associate degree in a healthcare related program along with 3 years of experience in health care, nursing, business, or finance.
• Additional requirements include 3 years of ICD-10-CM and/or CPT/HCPCS coding knowledge.
• This position requires an applicable CDIS or HIM (coding) credentialing through ACDIS, AHIMA, and/or AAPC.
• OR An LPN or RN licensure with three years of ICD-10 and/or CPT/HCPCS coding.
• Certified Clinical Documentation Specialist - Outpatient (CCDS-O) required within three years.
• This position requires an understanding and knowledge of physician documentation requirements in a clinic, outpatient, or inpatient setting to capture patients’ acute and chronic conditions.
• This position also requires an understanding how physician documentation is translated into ICD-10-CM diagnosis codes as well as how physician services and/or treatments rendered are translated into CPT codes, Level 1 or other HCPCS codes per physician or outpatient encounter.
• This position should have an understanding of the relationship between provider documentation, coded data, and CMs-1500 and UB-04 Claim reporting requirements in addition to the ability to navigate in various electronic health records.

Benefits

• Medical: Multiple plan options.
• Dental: Delta Dental or reimbursement account for flexible coverage.
• Vision: Affordable plan with national network.
• Pre-Tax Savings: HSA and FSAs for eligible expenses.
• Retail: Competitive retirement package to secure your future.