OP CDI Specialist

📋 Description

• • Review outpatient encounters (pre-visit, concurrent, and/or post-visit) to assess the accuracy and completeness of clinical documentation.
• • Identify opportunities for improved documentation related to chronic conditions, disease specificity, risk adjustment (e.g., HCCs), quality measures, and medical necessity.
• • Provide compliant documentation clarification through provider queries and feedback using approved communication channels and following AHIMA guidelines and CorroHealth policies.
• • Support accurate problem list management and ongoing validation of diagnosed conditions.
• • Collaborate with coding, quality, compliance, and revenue cycle teams to ensure alignment on documentation standards and reimbursement requirements.
• • Track, report, and analyze CDI interventions, trends, and outcomes to drive continuous improvement in documentation quality.
• • Participate in provider education and training initiatives to enhance clinical documentation practices.
• • Stay current on outpatient coding standards, risk adjustment models, and regulatory guidance including CMS, payer, and organizational requirements.
• • Identify potential compliance risks such as overcoding, undercoding, and unsupported or missing diagnoses.
• • Apply knowledge of HCCs, risk adjustment, quality measures, and outpatient reimbursement methodologies to ensure accurate documentation and billing.
• • Ensure all documentation practices comply with CMS, payer, and organizational billing and documentation regulations.
• • Utilize ambulatory EHR systems (e.g., Epic, Cerner, or similar) to access and review patient records.
• • Maintain high levels of accuracy and attention to detail in all documentation reviews and communications.
• • Work independently in a fast-paced environment while managing multiple priorities and deadlines.
• • Perform all duties with professional communication and strong written documentation skills.
• • Proficiently use Microsoft Office Applications for reporting, documentation, and data analysis.
• • Operate computer terminals for 6–8 hours daily with regular eye-hand coordination and manual dexterity.
• • Function effectively in an environment with frequent interruptions and prolonged sitting.
• • Occasionally lift and move materials weighing up to 20 lbs.
• • Maintain and access multiple patient files and documentation systems concurrently.
• • Work with diverse clients and projects with minimal supervision.