Outpatient CDI & HCC Specialist - Impactful Coding

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

Job summary

The Medical University Hospital Authority (MUHA) is seeking an Outpatient CDI Specialist to enhance documentation accuracy for outpatient encounters and improve risk adjustment. The role blends clinical documentation improvement with outpatient HCC coding and requires collaboration with physicians and coders.

Ideal candidates hold a nursing degree with SC or compact-state RN licensure and at least five years of clinical nursing experience, plus CDI/HCC exposure.

Qualifications

• Bachelor's degree in nursing and SC RN licensure required or compact state.
• Minimum five years of clinical nursing experience.
• Strong clinical knowledge and critical thinking skills.
• Experience with outpatient CDI, HCC coding, or both preferred.
• Experience in outpatient or acute care setting.
• Ability to work independently and communicate with physicians and staff.

Responsibilities

• Conduct concurrent and retrospective reviews to ensure documentation captures severity and medical necessity for outpatient services.
• Collaborate with physicians, nurse practitioners, case managers and coders to improve documentation of diagnoses, procedures and medical necessity.
• Query providers to address documentation gaps in a compliant manner.
• Educate providers and clinical staff on best practices for documentation to improve encounter accuracy and quality.
• Accurately assign ICD-10-CM codes for outpatient encounters and input data into EMR systems.
• Maintain HIPAA confidentiality and ensure compliance with regulatory standards.
• Serve as liaison between clinical staff and HIM to bridge documentation and coding requirements; participate in education on coding standards.

Skills

Clinical nursing experience

Critical thinking

Communication with physicians

Independent work

Education

Bachelor's degree in nursing

RN licensure in SC or compact state

Tools

EMR systems proficiency

Job description

The Medical University Hospital Authority (MUHA) is seeking an Outpatient CDI Specialist to enhance documentation accuracy for outpatient encounters and improve risk adjustment. The role blends clinical documentation improvement with outpatient HCC coding and requires collaboration with physicians and coders.

Ideal candidates hold a nursing degree with SC or compact-state RN licensure and at least five years of clinical nursing experience, plus CDI/HCC exposure.