Ambulatory CDI Specialist: Elevate RAF & HCC Outcomes

Lexington Medical Center

West Columbia (SC)

On-site

USD 70,000 - 105,000

Full time

8 days ago

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Benefits offered by this job

Day One benefits

FSAs

403(b) match plan

Employer paid life insurance

Supplemental life insurance

Adoption assistance

Disability coverage

Student loan forgiveness

Job summary

Lexington Health in West Columbia, SC, seeks an Ambulatory Clinical Documentation Integrity (CDI) Specialist to lead reconciliation reviews of ambulatory records, identify HCC diagnoses, and improve RAF scores. You will query providers to ensure complete and accurate documentation that reflects patient severity of illness.

The role requires an Associate's Degree in Nursing, an active RN license, and CDI/coding or risk adjustment experience.

Qualifications

Strong communication skills are required to coordinate with physicians and care teams.
Maintain strict confidentiality of patient information and hospital data as per privacy regulations.
Experience with CDI/coding or risk adjustment is preferred for ambulatory or acute care settings.

Responsibilities

Conduct prospective and retrospective reviews of ambulatory records to identify HCC diagnoses.
Query providers to ensure accurate documentation supporting HCC and RAF scores.
Educate care teams on CDI requirements and documentation improvements.
Collaborate with physicians and care teams to resolve documentation discrepancies.
Maintain compliance with ICD-10-CM coding and risk adjustment guidelines.
Develop educational materials and present CDI information to providers.