Clinical Documentation Integrity (CDI) Specialist

Curana Health, Inc.

118d

About The Position

As a Clinical Documentation Integrity (CDI) Specialist, you’ll play a critical role in ensuring our medical documentation tells the true story of each member’s health journey. Your expertise helps us drive accurate coding, optimize quality metrics, and support compliance—all while improving care for the populations we serve.

Requirements

• Registered Health Information Administrator (RHIA, AHIMA) certification.
• Certified Risk Adjustment Coder (CRC) or Clinical Documentation Expert Outpatient (CDEO, AAPC) certification.
• 2+ years of experience with CPT/HCPCS coding.
• Background in risk adjustment, provider training, and RADV work.
• Strong grasp of CMS HCC model, ICD-10, CPT/HCPCS, and HIPAA requirements.
• Hands-on experience with medical record reviews and audits.
• Analytical mindset with advanced proficiency in Microsoft Office tools.
• Strong interpersonal skills with the ability to influence provider behavior and drive quality outcomes.

Responsibilities

• Review inpatient and outpatient medical records, abstract key data, and ensure ICD-10-CM codes accurately reflect the patient’s story.
• Partner with providers to identify opportunities for more complete documentation that supports severity of illness, risk adjustment, and quality outcomes.
• Apply coding guidelines, evidence-based knowledge, and CMS requirements to improve coding quality and audit readiness.
• Respond to provider and internal team inquiries, lead provider training sessions, and strengthen vendor relationships.
• Maintain up-to-date knowledge of ICD-10-CM, CPT/HCPCS, RADV requirements, and state/federal regulations to keep our compliance strong.
• Support RADV audits and coding quality initiatives using official coding guidelines and internal protocols.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Bachelor's degree