OP CDI Specialist

CorroHealth•TX-Remote, TX

6d•Remote

About The Position

CDI Specialists will collaborate extensively with physicians, nursing staff, other patient caregivers, and medical records coding staff to improve the quality, specificity, accuracy and completeness of the documentation of care provided and coded. CDI Specialist will review medical records for opportunities for diagnosis clarification and validity as it pertains to DRG assignment, severity of illness, risk of mortality, and case mix data as well as timely, accurate and complete documentation of clinical information used for measuring and reporting physician and facility outcomes. These goals will be accomplished by chart review and query placement when appropriate following AHIMA guidelines and CorroHealth policies and procedures.

Requirements

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)
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

Nice To Haves

Experience with telecommuting, working with EMRs and other electronic tools.
Strong analytical skills.
Strong Microsoft Office skills.
Works well with numbers.
Strong team player.
Ability to work with multiple and diverse clients and projects.
Ability to work with minimal supervision.
Ability to maintain and access multiple files.
Assure that work product is completed with high levels of accuracy and attention to detail.
CCDS, CDEI, or CDIP certification required.
Current clinical license (RN, NP, PA, MD).
Two years CDI experience.
Two years or more clinical experience in an acute care setting preferred.
Coding professional with CCS or RHIT/RHIA and CDI credential.
Minimum three years CDI experience in IP CDI reviews required.

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
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.