Associate, Clinical Documentation Integrity (Risk Adjustment)

Cityblock Health; United States; Remote; USD 60,000 - 100,000; Full time

Job summary

Join a pioneering healthcare provider focused on improving health outcomes in underserved communities. As a Clinical Documentation Improvement Specialist, you will play a vital role in enhancing clinical documentation accuracy, working collaboratively with teams to ensure compliance and quality. This position offers the chance to make a significant impact while leveraging your expertise in coding and documentation. With a commitment to diversity and equity, this innovative organization is dedicated to meeting the needs of its members where they are, making healthcare accessible and effective. If you're passionate about improving community health, this role is perfect for you.

Benefits

Health Insurance

Life Insurance

Retirement Benefits

Equity Program

Paid Time Off

Qualifications

• 5+ years of experience with 3+ years in CDI and 2+ years in outpatient HCC coding.
• Knowledge of medical terminology, disease processes, and risk adjustment.

Responsibilities

• Review visits to validate chronic conditions and assess potential suspect conditions.
• Ensure compliance with documentation rules and coding guidelines.

Skills

Clinical Documentation Improvement

ICD-10-CM Coding

Risk Adjustment Knowledge

Medical Terminology

Provider Education

Education

High School Diploma

CPC or CCS Certification

Tools

Google Suite

Microsoft Office

EHR Systems

Job description

Associate, Clinical Documentation Integrity (Risk Adjustment)

Apply remote type Remote locations USA time type Full time posted on Posted 29 Days Ago job requisition id R-903

Job Description:

About the Role

The Clinical Documentation Improvement (CDI) Specialist will play a critical role in creating a culture of best-in-class clinical documentation accuracy in support of building a model of care focused on quality and health outcomes. The role will require working closely with our Burden of Illness, Clinical, and Compliance teams to participate in our Clinical Documentation Integrity program and leverage your clinical, coding, and documentation expertise to foster improvements in the overall quality, completeness, and compliance of clinical documentation.

Responsibilities

1. Review upcoming visits to validate persistent (chronic) conditions and raise potential suspect conditions for provider to assess.
2. Utilize various systems to find clinical support to assist in closing risk adjustment gaps.
3. Responsible for ensuring documentation rules, coding guidelines and company compliance guidelines are met.
4. Perform assessments of data to improve overall operations and identify opportunities for provider education and optimization.
5. Serve as a subject matter expert on HCC documentation requirements and ICD-10-CM coding guidelines (Medicaid documentation requirements understanding is a plus).
6. Develop and support strong professional relationships with medical providers across the organization.

Requirements for the Role

1. HS Diploma.
2. Certification Required: CPC, CCS or equivalent.
3. 5+ years of overall experience; 3+ years of CDI-specific experience and 2+ years of outpatient HCC coding experience.
4. Knowledge of medical terminology, physiology, pharmacology, and disease processes and related procedures. Knowledge of risk adjustment (HCCs), guiding principles, and reimbursement methodology.
5. Proficiency with Google Suite and Microsoft Office, experience navigating EHR’s and various systems to complete assigned tasks.

We take into account an individual’s qualifications, skillset, and experience in determining final salary. This role is eligible for health insurance, life insurance, retirement benefits, participation in the company’s equity program, paid time off, including vacation and sick leave. The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location.

Cityblock values diversity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

Covid 19 Update - Please Read:

Cityblock requires those hired into this position to provide proof that they have received the COVID-19 vaccine. Any individuals subject to this requirement may submit for consideration a request to be exempted from the requirement (based on a valid religious or medical reason) on forms to be provided by Cityblock. Such requests will be subject to review and approval by the Company, and exemptions will be granted only if the Company can provide a reasonable accommodation in relation to the requested exemption.

About Us:

Cityblock Health is the first tech-driven provider for communities with complex needs—bringing better care to where it’s needed most, block by block. Founded in 2017 on the premise that “health is local” and based in Brooklyn, we are backed by Alphabet’s Sidewalk Labs along with some of the top healthcare investors in the country.

Our mission is to improve the health of underserved communities. Importantly, our solutions are designed specifically for Medicaid and lower-income Medicare beneficiaries, and we meet our members where they are, bringing care into the home and neighborhoods through our community-based care teams and Virtual Care offerings.

Our work is grounded in a belief in the power of a diverse community. To close gaps in care and advance equity in the communities we serve, we have to start with making our own team diverse and inclusive.