Outpatient CDI & HCC Coding Specialist

Medical University of South Carolina; South Carolina; Hybrid; USD 75,000 - 110,000; Full time

Job summary

Medical University of South Carolina seeks an Outpatient CDI Specialist to enhance outpatient documentation and coding accuracy. The role blends CDI and HCC coding to improve risk capture and reimbursement while ensuring compliance with guidelines.

Requires a BSN and 3+ years in clinical nursing, with RN licensure in SC or a compact state. The position emphasizes collaboration with clinicians and coding teams in a hybrid work setting.

Qualifications

• Bachelor's degree in nursing from an accredited school of nursing and at least three years' clinical nursing experience preferred.
• Licensure as a registered nurse by the South Carolina Board of Nursing or compact state.
• Strong clinical experience and critical thinking skills required.
• Extensive knowledge of patient care, and knowledge of clinical measurement tools and clinical outcomes.
• Ability to establish cooperative working relationships with diverse groups and individuals, medical staff and other health care disciplines.

Responsibilities

• Clinical Documentation Improvement: Conduct concurrent and retrospective reviews to ensure documentation captures severity, risk of mortality, and medical necessity for outpatient services.
• Collaborate with physicians, nurses, case managers and coders to identify opportunities for improving documentation of diagnoses, procedures and medical necessity.
• Query providers in a compliant and clear manner to address documentation gaps and support accurate coding and billing.
• Educate providers and clinical staff on best practices for documentation to improve encounter accuracy and quality.
• Outpatient HCC Coding: Accurately assign ICD-10 CM for outpatient encounters and input into EMR while adhering to coding standards.

Skills

RN experience

Clinical documentation

Collaboration

Education

Bachelor's degree in nursing

Job description

Medical University of South Carolina seeks an Outpatient CDI Specialist to enhance outpatient documentation and coding accuracy. The role blends CDI and HCC coding to improve risk capture and reimbursement while ensuring compliance with guidelines.

Requires a BSN and 3+ years in clinical nursing, with RN licensure in SC or a compact state. The position emphasizes collaboration with clinicians and coding teams in a hybrid work setting.