Outpatient CDI & HCC Coding Specialist

musc; United States; Hybrid; USD 90,000 - 120,000; Full time

Job summary

Medical University Hospital Authority (MUHA) seeks an Outpatient CDI Specialist to join a hybrid role combining CDI and outpatient HCC coding. The role reports to the Outpatient CDI supervisor and aims to enhance documentation accuracy, quality, and completeness in outpatient medical records while ensuring coding guidelines are followed.

The position collaborates with providers, coding teams, and healthcare professionals to optimize reimbursement and reflect true severity of illness and care.

Qualifications

• Bachelor's degree in nursing and RN licensure with 3+ years of clinical/ CDI experience preferred.
• Active RN licensure by SC Board or compact state is required.
• Experience in outpatient CDI or HCC coding preferred.

Responsibilities

• Conduct concurrent and retrospective reviews to capture full patient severity and medical necessity for outpatient services.
• Collaborate with physicians, nurse practitioners, case managers, and coders to improve documentation.
• Query providers to address documentation gaps supporting accurate coding and billing.
• Educate providers and staff on best practices for documentation to improve accuracy.
• Assign ICD-10-CM codes for outpatient encounters and ensure compliance with guidelines.
• Abstract data into EMR while adhering to coding standards and regulatory requirements.
• Maintain confidentiality and HIPAA compliance in all documentation activities.

Skills

Clinical knowledge

Communication skills

Critical thinking

Team collaboration

Education

Bachelor's degree in Nursing

Registered Nurse license (SC Board or compact state)

Tools

ICD-10-CM proficiency

EMR systems

Job description

Medical University Hospital Authority (MUHA) seeks an Outpatient CDI Specialist to join a hybrid role combining CDI and outpatient HCC coding. The role reports to the Outpatient CDI supervisor and aims to enhance documentation accuracy, quality, and completeness in outpatient medical records while ensuring coding guidelines are followed.

The position collaborates with providers, coding teams, and healthcare professionals to optimize reimbursement and reflect true severity of illness and care.