Outpatient CDI Specialist - Documentation & Quality Impact

Joint Township District Memorial Hospital; United States; On-site; USD 60,000 - 90,000; Full time

Job summary

Grand Lake Health System is seeking a Coding Specialist with expertise in documentation review and medical coding to ensure accuracy and compliance across ICD, CPT, HCPCS Level II, HEDIS CPT II, and RAF coding. The role emphasizes risk adjustment, quality reporting, and payer policy adherence.

Responsibilities include supporting clinicians, educators, and interdisciplinary teams to improve documentation quality, reduce denials, and align coding practices with federal regulations.

Qualifications

• Must have an associate degree in healthcare or related field.
• Must have training in medical terminology, anatomy, and physiology.
• Must have coding certification (CDEO, CCDS-O, CPC or CCS) or equivalent experience.
• Experience with medical documentation, coding guidelines, and payer policies.

Responsibilities

• Conduct core documentation review and ensure coding accuracy.
• Assess documentation for completeness and compliance with coding guidelines.
• Link provider documentation to ICD, CPT, HCPCS Level II, HEDIS CPT II, and RAF codes.
• Support risk adjustment reporting and quality initiatives.
• Educate providers and collaborate with coding, billing, and clinical staff.

Skills

Observation skills

Analytical thinking

Problem solving

Verbal and written communication

Presentation skills

Remote Teams communication

Education

Associate’s degree in Healthcare, Nursing or related field

Training in medical terminology, anatomy, physiology

Coding certification (CDEO, CCDS-O, CPC or CCS)

Tools

Coding encoders

Job description

Grand Lake Health System is seeking a Coding Specialist with expertise in documentation review and medical coding to ensure accuracy and compliance across ICD, CPT, HCPCS Level II, HEDIS CPT II, and RAF coding. The role emphasizes risk adjustment, quality reporting, and payer policy adherence.

Responsibilities include supporting clinicians, educators, and interdisciplinary teams to improve documentation quality, reduce denials, and align coding practices with federal regulations.