Outpatient CDI & HCC Coding Specialist

Medical University of South Carolina; United States; Hybrid; USD 90,000 - 120,000; Full time

Job summary

Medical University of South Carolina (MUSC) is seeking an Outpatient CDI Specialist to enhance clinical documentation and outpatient HCC coding. The role reports to the Outpatient CDI supervisor and collaborates with providers, coding teams, and HIM to improve accuracy, quality, and compliance in outpatient records.

The position combines CDI expertise with outpatient coding to optimize reimbursement while reflecting true illness severity.

Qualifications

• Active RN license in SC or compact state.
• 5+ years clinical nursing experience preferred.
• Experience in CDI and/or coding (RHIA, RHIT, CPC, CRC, CCS) is a plus.

Responsibilities

• Conduct concurrent reviews to ensure documentation captures the full scope of patient severity, risk of mortality, and medical necessity for outpatient services.
• Collaborate with physicians, nurse practitioners, 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, ambiguities, or discrepancies to support accurate coding and billing.
• Educate providers and clinical staff on best practices for documentation to improve outpatient encounter accuracy and quality.

Skills

RN experience

Clinical documentation improvement

HCC/Risk Adjustment

Communication skills

Education

High School Diploma or equivalent

Associate or Bachelor’s degree in nursing

Bachelor’s degree in nursing preferred

Job description

Medical University of South Carolina (MUSC) is seeking an Outpatient CDI Specialist to enhance clinical documentation and outpatient HCC coding. The role reports to the Outpatient CDI supervisor and collaborates with providers, coding teams, and HIM to improve accuracy, quality, and compliance in outpatient records.

The position combines CDI expertise with outpatient coding to optimize reimbursement while reflecting true illness severity.