Clinical Documentation Integrity Specialist (CDIS)

firsthand

83d • $33 - $33

About The Position

firsthand supports individuals living with SMI (serious mental illness). Our holistic approach includes a team of peer recovery specialists, benefits specialists and clinicians. Our teams focus on meeting each individual where they are and walking with them side by side as a trusted guide and partner on their journey to better health. firsthand's team members use their lived experience to build trust with these individuals and support them in reconnecting to the healthcare they need, while minimizing inappropriate healthcare utilization. Together with our health plan partners, we are changing the way our society supports those most impacted by SMI. We are cultivating a team of deeply passionate problem-solvers to tackle significant and complex healthcare challenges with us. This is more than a job—it's a calling. Every day, you will engage in work that resonates with purpose, gain wisdom from motivated colleagues, and thrive in an environment that celebrates continuous learning, creativity, and fun.

Requirements

• Certified Risk Adjustment Coder (CRC) or Certified Professional Coder (CPC) from AAPC in good standing.
• An Associate’s or Bachelor’s degree in a healthcare related field with RHIA, RHIT, CRC or CCS credential, RN or LPN license is required.
• Minimum of 5 years of risk adjustment-focused medical record review and ICD-10 coding experience, specifically using the Medicare HCC model, in multiple settings (e.g., inpatient, outpatient).
• Fluent knowledge of ICD-10 CM Official Guidelines for Coding and Reporting, and AHA/AMA/CMS coding resources, to support audit findings.
• Ability to gain proficiency in and apply productivity tools, such as spreadsheets, Google Suite, and EHR systems.
• Excellent written and verbal communication skills, especially to maintain working relationships with firsthand providers (APNs, NPs), other CDISs, Medical Records Specialists, and others.
• Proven experience working remotely.
• Alignment to firsthand’s mission, vision and values: Demonstrate respect, dignity, empathy, and professional conduct to both individuals that firsthand serves and firsthand team members.

Nice To Haves

• Familiarity with Medicaid risk models, such as CDPS or ACG.

Responsibilities

• Perform prospective, retrospective, and concurrent coding reviews based on evaluations of prior visit documentation, lab results, images, external medical records, payer claims data, and more.
• Demonstrate an understanding of complications, comorbidities, case mix and the impact of procedures on the billed record as well as the ability to impart this knowledge to providers and other members of the healthcare team.
• Support pre-visit planning by communicating to firsthand providers individuals’ potential chronic conditions and care gaps with robust and appropriate evidence.
• Ensure accurate, timely, and comprehensive clinical documentation to support code capture, including querying providers when these clinical documentation standards are not met.
• Support medical records requests when providers require additional information prior to addressing and diagnosing potential conditions.
• Work with team leadership to identify chronic condition prevalence trends by individuals’ demographics; identify and execute potential interventions, e.g., ongoing education to firsthand providers and the CDI team, ongoing quarterly retrospective reviews of unaddressed suspects.

Benefits

• For full-time employees, our compensation package includes base, equity (or a special incentive program for clinical roles) and performance bonus potential.
• Our benefits include physical and mental health, dental, vision, 401(k) with a match, 16 weeks parental leave for either parent.
• 15 days/year vacation in your first year (this increases to 20 days/year in your second year and beyond).
• A supportive and inclusive culture.

What This Job Offers

• Job Type: Part-time
• Career Level: Entry Level
• Education Level: Bachelor's degree
• Number of Employees: 101-250 employees