Outpatient CDI Specialist-Hybrid

Mayo Clinic•Rochester, MN

76d•$72,758 - $101,816•Hybrid

About The Position

Mayo Clinic is a top-ranked healthcare provider dedicated to patient needs and employee well-being. They offer competitive compensation, comprehensive benefits, and opportunities for career advancement. This hybrid position requires building strong relationships with clinicians, administrators, and revenue cycle colleagues. The role involves understanding various payment structures, fee schedules, and reimbursement methodologies in the outpatient setting. A key aspect is translating physician documentation into ICD-10-CM and HCPCS/CPT codes for claims submission, meeting reporting requirements. The specialist will educate physicians and administration, track case reviews, and report on results. They will serve as a subject matter expert on how provider documentation influences accurate coding of outpatient services, requiring strong prioritization and organizational skills to manage competing demands and deadlines.

Requirements

Must be located within 100 miles of any of the Mayo Clinic campuses for on-site expectations.
Minimum of an Associate degree in a healthcare related program.
3 years of experience in health care, nursing, business, or finance.
3 years of ICD-10-CM and/or CPT/HCPCS coding knowledge.
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.
Understanding and knowledge of physician documentation requirements in a clinic, outpatient, or inpatient setting to capture patients’ acute and chronic conditions.
Understanding how physician documentation is translated into ICD-10-CM diagnosis codes.
Understanding how physician services and/or treatments rendered are translated into CPT codes, Level 1 or other HCPCS codes per physician or outpatient encounter.
Understanding of the relationship between provider documentation, coded data, and CMs-1500 and UB-04 Claim reporting requirements.
Ability to navigate in various electronic health records.
Not eligible for sponsorship / will not sponsor or transfer visas for this position.

Responsibilities

Build strong working relationships with Clinicians, Administrators, and Revenue Cycle colleagues.
Possess strong communication skills to bridge and connect interrelated concepts, business functions, and processes.
Understand various payment structures, fee schedules, and reimbursement methodologies in the outpatient setting and with physician encounters.
Understand how physician documentation translates into ICD-10-CM and HCPCS/CPT codes for claims submission to meet reporting requirements.
Create and effectively deliver presentations educating physicians, group practices, and administration.
Individually track, monitor, and report on case reviews and document results achieved.
Prioritize and organize time and materials, addressing physician documentation and education needs amidst competing priorities and deadlines.
Serve as a subject matter expert in how proper provider documentation drives accurate coding of outpatient services.