Outpatient CDI & HCC Coding Specialist

UCLA Health and David Geffen School of Medicine; South Carolina; Hybrid; USD 75,000 - 95,000; Full time

Job summary

Medical University Hospital Authority (MUHA) seeks an Outpatient CDI Specialist to join a hybrid team focused on improving outpatient documentation and HCC coding. You will work with providers, coding staff and HIM to ensure accurate coding and compliant reimbursement for outpatient services.

The role emphasizes concurrent and retrospective reviews, education for clinicians, and data integrity while maintaining HIPAA and regulatory standards.

Qualifications

• Bachelor's degree in nursing from an accredited school of nursing is required or preferred.
• Active RN license in SC or compact state.
• 3+ years clinical nursing experience with CDI or coding experience preferred.

Responsibilities

• Conduct concurrent and retrospective reviews to ensure documentation supports severity and medical necessity.
• Collaborate with physicians, nurses, coders, and health information management to improve documentation and coding.
• Query providers to address documentation gaps in a compliant manner.
• Educate providers on documentation and coding best practices for outpatient services.

Skills

RN license

Critical thinking

Outpatient CDI

HCC knowledge

Education

BSN

Tools

ICD-10-CM

Job description

Medical University Hospital Authority (MUHA) seeks an Outpatient CDI Specialist to join a hybrid team focused on improving outpatient documentation and HCC coding. You will work with providers, coding staff and HIM to ensure accurate coding and compliant reimbursement for outpatient services.

The role emphasizes concurrent and retrospective reviews, education for clinicians, and data integrity while maintaining HIPAA and regulatory standards.