Hybrid Outpatient CDI & HCC RN Specialist

C002 Medical University Hospital Authority (MUHA); South Carolina; Hybrid; USD 95,000 - 125,000; Full time

Job summary

Medical University of South Carolina is seeking an Outpatient CDI Specialist who combines clinical documentation improvement with outpatient HCC coding. The role reports to the Outpatient CDI Program Manager and collaborates across providers, coding teams and care teams to improve documentation, risk capture and reimbursement.

The position requires a Bachelor’s in nursing, RN licensure, and at least five years of clinical nursing experience with strong communication skills.

Qualifications

• Bachelor's degree in nursing required; five years' clinical nursing preferred.
• Strong clinical and critical thinking skills required.
• Knowledge of patient care and clinical outcomes; ability to work with diverse teams.
• Licensed as a registered nurse by SC Board or compact state.

Responsibilities

• Conduct concurrent and retrospective reviews to ensure documentation captures severity, risk, and medical necessity for outpatient services.
• Collaborate with physicians, nurse practitioners, case managers and coders to improve documentation.
• Query providers to address gaps for accurate coding and billing.
• Educate providers and staff on documentation best practices to improve encounter accuracy.
• Accurately assign ICD-10-CM for outpatient encounters and ensure coding accuracy meets 95%.

Skills

RN licensure

Clinical nursing

HCC coding

Communication with physicians

Education

Bachelor's degree in nursing

Tools

ICD-10-CM proficiency

Job description

Medical University of South Carolina is seeking an Outpatient CDI Specialist who combines clinical documentation improvement with outpatient HCC coding. The role reports to the Outpatient CDI Program Manager and collaborates across providers, coding teams and care teams to improve documentation, risk capture and reimbursement.

The position requires a Bachelor’s in nursing, RN licensure, and at least five years of clinical nursing experience with strong communication skills.