Risk Adjustment CDI Analyst

AdventHealth-posted 11 months ago
Full-time • Mid Level
Altamonte Springs, FL
1,001-5,000 employees
Ambulatory Health Care Services
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The Risk Adjustment CDI Analyst performs pre-visit and retrospective reviews of ambulatory clinical documentation to ensure accurate depiction of the true complexity of the patient for compliant documentation to support the capture or Hierarchical Condition Categories (HCC), ICD-10-CM accuracy and specificity. The role will work collaboratively with Coding and Documentation Educators to communicate documentation and coding opportunities service-line specific requirements.

  • Perform pre-visit and retrospective reviews of ambulatory clinical documentation to ensure accurate and compliant documentation to support the capture of Hierarchical Condition Categories (HCC) and ICD-10-CM accuracy and specificity.
  • Utilize deep knowledge of current CMS coding guidelines, conventions, and AHA coding clinics to improve the overall quality and completeness of the patient medical record.
  • Facilitate appropriate modifications to clinical documentation to accurately reflect patient severity of illness and risk through extensive interaction with Coding and Documentation Educators.
  • Collaborate with coding staff to develop standard coding guidelines, policies, and procedures under the guidance of the Director and Manager.
  • Demonstrate knowledge of documentation requirements and coding guidelines that pertain to outpatient diagnosis coding.
  • Meet and maintain productivity and accuracy metrics and standards as defined.
  • Work closely with healthcare providers, physicians, and other coding professionals to clarify documentation and ensure coding reflects the severity of illnesses and chronic conditions.
  • Minimum of four years of healthcare experience
  • Minimum of four years' experience in HCC coding
  • Experience with Medicare risk adjustment, Hierarchical Condition Categories (HCC), coding, billing, auditing, and various healthcare payers.
  • One of the following certifications: CPC, CCS (Certified Professional Coder), CDIP, CCDS-O
  • Prior medical record review experience
  • Strong ambulatory background with a focus on diagnostic coding
  • CRC, CCDS
  • Benefits from Day One
  • Paid Days Off from Day One
  • Career Development
  • Whole Person Wellbeing Resources
  • Mental Health Resources and Support
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