Hybrid CDI Specialist - Risk Adjustment

Stanford Health Care; California; Hybrid; USD 89,000 - 118,000; Full time

Job summary

Stanford Health Care in Palo Alto is seeking a Clinical Documentation Specialist-Risk Adjustment to conduct code audits and abstractions aligned with state and federal regulations. You will support risk adjustment programs through education, QA activities, and collaboration with clinicians and departments.

The role requires a Bachelor’s degree in a related field and 5+ years in healthcare, including risk adjustment, with strong CPT/HCPCS/ICD-10 knowledge.

Qualifications

• Bachelor’s degree in Nursing, Medicine, Health Information Management or related field.
• Over 5 years of healthcare experience, including 2–5 years in a risk adjustment program.
• Knowledge and application of CPT, HCPCS and ICD-10 coding rules.
• Ability to analyze complex coding and regulatory guidelines.

Responsibilities

• Maintains liaison with clinicians on documentation integrity strategies and requests clarification.
• Performs prospective and concurrent CDI workflows and retrospective audits.
• Review medical records to ensure accurate HCC coding and identify recapture opportunities.
• Verify MEAT criteria support for submitted diagnosis codes.
• Collaborate with departments to address coding updates and support risk adjustment programs.
• Track and report review results to educate and train on risk adjustment coding and documentation.

Skills

CDI knowledge

Healthcare experience

Clinician communication

Regulatory knowledge

Education

Bachelor’s degree in Nursing/Medicine/Health Information Management

Master’s degree

Job description

Stanford Health Care in Palo Alto is seeking a Clinical Documentation Specialist-Risk Adjustment to conduct code audits and abstractions aligned with state and federal regulations. You will support risk adjustment programs through education, QA activities, and collaboration with clinicians and departments.

The role requires a Bachelor’s degree in a related field and 5+ years in healthcare, including risk adjustment, with strong CPT/HCPCS/ICD-10 knowledge.