Outpatient CDI Specialist: Drive Accurate Coding

Illinois Bone & Joint Institute; Park Ridge (IL); On-site; USD 85,000 - 115,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

AD&D insurance

Disability insurance

401(k) with company match

Profit sharing

Wellness program

Health savings account

Flexible spending accounts

Paid holidays

Paid time off

Job summary

Illinois Bone & Joint Institute is seeking an Outpatient Clinical Documentation Integrity Specialist to enhance accuracy, completeness, and integrity of outpatient documentation and coding across Illinois. You will conduct prospective and retrospective audits, provide timely feedback, manage send-backs, and work closely with coding, Revenue Cycle, and Epic teams to support compliant charge capture.

The role involves auditing AI-assisted coding output, identifying opportunities, monitoring

Qualifications

• Associate degree in Health Information Management or related field.
• Current professional coding credential such as CPC, CCS, CCS‑P or equivalent preferred.
• Minimum of three years of professional outpatient coding, coding auditing, CDI, or Revenue Integrity experience preferred.
• Orthopedic, musculoskeletal, or multi-specialty physician practice experience strongly preferred.
• Experience with Epic, including professional billing workflows, workqueues, edits, or reporting, preferred.
• Experience reviewing computer‑assisted coding, autonomous coding, or AI‑supported coding solutions preferred.
• Strong knowledge of ICD‑10‑CM, CPT, HCPCS, modifiers, E/M coding, NCCI edits, and professional fee coding guidelines.
• Ability to interpret clinical documentation, payer policies, and coding guidance and apply them consistently to outpatient services.

Responsibilities

• Performs prospective and retrospective audits of outpatient clinical documentation, coding, and charge capture to validate accuracy, completeness, medical necessity, and compliance with applicable coding and payer requirements.
• Reviews provider documentation and coded services for appropriate diagnosis, CPT, HCPCS, modifier, and E/M code selection and identifies opportunities for clarification or correction.
• Provides clear, timely, and actionable feedback to physicians, advanced practice providers, coders, and operational teams regarding documentation and coding findings.
• Develops and delivers provider education based on audit findings, coding trends, payer changes, regulatory guidance, and identified documentation opportunities.
• Manages and monitors documentation and coding send‑backs, including appropriate follow‑up with providers and coders to support timely resolution and claim submission.
• Partners with coding leadership and coding staff to review recurring coding questions, reconcile documentation and coding discrepancies, and promote consistent coding practices.
• Coordinates with the Epic team on Revenue Cycle and CDI‑related workflow, edit, workqueue, reporting, charge capture, and documentation enhancement opportunities; participates in testing and user acceptance testing (UAT) as needed.
• Audits AI‑assisted and automated coding output for accuracy, compliance, and consistency; identifies error patterns, documents findings, and collaborates with coding and technology teams on corrective actions and optimization.
• Supports Revenue Integrity activities, including review of charge capture, missed or incorrect charges, coding edits, modifier use, billing rules, and workflow opportunities that may affect compliant reimbursement.
• Identifies trends that may contribute to denials, claim edits, delayed billing, coding rework, or revenue leakage and partners with Revenue Cycle teams to develop sustainable solutions.
• Assists with the development and maintenance of coding, CDI, and Revenue Integrity policies, procedures, tip sheets, education materials, and standardized workflows.
• Tracks and reports audit results, provider education activity, send‑back volumes, error trends, and improvement opportunities; escalates significant or recurring findings to leadership.
• Participates in Revenue Cycle change control, Epic optimization, and process improvement initiatives that impact coding, documentation, charge capture, and claims.
• Maintains current knowledge of ICD‑10‑CM, CPT, HCPCS, NCCI edits, payer policies, Medicare requirements, and other applicable coding and billing guidance.
• Maintains confidentiality of patient information in accordance with HIPAA and organizational policies.
• Supports departmental goals, quality initiatives, and other Revenue Cycle responsibilities as assigned.
• Maintain a clean and safe work environment.
• Other duties as assigned

Skills

Communication

Collaboration

Detail-oriented

Prioritization

Independence

Professionalism

Curiosity

ICD-10-CM coding

CPT coding

HCPCS coding

NCCI edits

Epic

Data reporting tools

Education

HIM/Health IT degree

Tools

Epic

Microsoft Office

Job description

Illinois Bone & Joint Institute is seeking an Outpatient Clinical Documentation Integrity Specialist to enhance accuracy, completeness, and integrity of outpatient documentation and coding across Illinois. You will conduct prospective and retrospective audits, provide timely feedback, manage send-backs, and work closely with coding, Revenue Cycle, and Epic teams to support compliant charge capture.

The role involves auditing AI-assisted coding output, identifying opportunities, monitoring