Remote Outpatient CDI Specialist: Risk & Documentation

Boldage-Pace; Oceanport (NJ); On-site; USD 90,000 - 115,000; Full time

Benefits offered by this job

Generous Paid Time Off

401K with Match*

Life Insurance

Tuition Reimbursement

Flexible Spending Account

Employee Assistance Program

Job summary

BoldAge PACE seeks an Outpatient Clinical Documentation Integrity (CDI) Specialist to enhance accuracy, completeness, and compliance of clinical documentation across our multi-facility PACE healthcare system. You will conduct prospective, concurrent, and retrospective chart reviews to support HCC capture, RAF accuracy, ICD-10-CM coding, and regulatory compliance.

The role partners with providers, coding professionals, finance, revenue cycle, and interdisciplinary teams to ensure diagnoses are

Qualifications

• Minimum of three (3) years of clinical documentation improvement, outpatient CDI, risk adjustment, HCC coding, or related healthcare documentation experience.
• Experience with Medicare Advantage, Medicaid, and/or PACE populations preferred.

Responsibilities

• Performs prospective, concurrent, and retrospective chart reviews across outpatient settings to identify documentation gaps.
• Supports compliant HCC capture and RAF accuracy for CMS programs.
• Develops compliant provider queries when documentation requires clarification or additional specificity.
• Educates providers on documentation specificity and CMS requirements through collaborative feedback.
• Collaborates with coding and interdisciplinary teams to improve documentation integrity and care planning.

Skills

Analytical skills

CMS knowledge

Documentation review

Education

RN/PA/NP/MD/DO license

CDI/coding certification

Tools

ICD-10-CM Guidelines

CMS Risk Adjustment models

MEAT criteria

Job description

BoldAge PACE seeks an Outpatient Clinical Documentation Integrity (CDI) Specialist to enhance accuracy, completeness, and compliance of clinical documentation across our multi-facility PACE healthcare system. You will conduct prospective, concurrent, and retrospective chart reviews to support HCC capture, RAF accuracy, ICD-10-CM coding, and regulatory compliance.

The role partners with providers, coding professionals, finance, revenue cycle, and interdisciplinary teams to ensure diagnoses are