Outpatient Clinical Documentation Integrity (CDI) Specialist

Delfi Diagnostics


Clinical Account Executive
Delfi Diagnostics • via Remote Rocketship
2 days ago
$1.2L–$1.55L a year
Full–time
Apply on Remote Rocketship
Apply on ZipRecruiter
Apply on Ladders
Apply on DailyRemote
Job description
Description:
• As a Clinical Account Representative, you will promote our innovative, first of its class to market, FirstLook Lung test to healthcare providers.
• This role will be responsible for building strong relationships, and driving sales growth in their assigned territory.
• This role is an excellent fit for someone who enjoys promoting cutting edge diagnostic technology while working in a highly collaborative and cross-functional environment.
• Applicants must be located within 100 miles of Pittsburgh, PA
• DELFI has 1-2 designated in-office working days each week for employees who live within within 50 miles of Palo Alto, CA or Baltimore, MD offices

Requirements:
• Residence within 100 miles of Pittsburgh, PA
• Bachelor’s degree in life sciences, business, or a related field
• 5+ years of proven sales experience in the diagnostics industry
• Strong understanding of laboratory practices and diagnostic testing
• Excellent communication and interpersonal skills
• Ability to work independently and as part of a team
• Willingness to travel within the assigned territory (40 - 50%)
• Experience working in a startup environment

Benefits:
• 100% paid medical, dental and vision premiums for employees and dependents
• 4 months fully paid parental leave
• Flexible Time Off
• 5 day winter break in December
• A meaningful mission and strong company culture
Report this listing
Delfi Diagnostics
Glassdoor
4.6/5
22 reviews
delfidiagnostics.com
More jobs at Delfi Diagnostics
See web results for Delfi Diagnostics

Fairview Health Services


Outpatient Clinical Documentation Integrity (CDI) Specialist
Fairview Health Services • St Paul, MN, United States • via Indeed
Full–time
Apply directly on Indeed
Apply on Glassdoor
Apply on Monster
Apply on Snagajob
Apply on Winsomejobs
Apply on Recruiter Jobs
Apply on USA Remote Job Ca MySmartPros
Apply on Remote Jobs In USA
Job highlights
Identified by Google from the original job post
Qualifications
Associate degree in HIM, or equivalent healthcare coding experience
Required Experience
At least 2-3 years coding experience required; or a combination of 1-2 years coding experience and HCC Capture, Risk Adjustment or Outpatient CDI experience
Demonstrated extensive critical-thinking skills, and understanding of disease processes, anatomy, pathophysiology, and disease management/treatment required
Demonstrated knowledge of current coding guidelines and methodologies: HCCs, ICD-10-CM coding guidelines, clinics, and conventions required
Outpatient or Professional Fee Coding: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Certified Coding Specialist - Professional (CCS-P), Certified Professional Coder - Hospital (CPC-H), Certified Clinical Documentation Specialist-Outpatient (CCDS-O), Certified Risk Adjustment Coder (CRC)
Proficiency with Microsoft Office (Teams, Excel, PowerPoint, Word, Outlook) required
Proficiency with electronic medical record (EMR) required
Responsibilities
This is a fully remote position that is approved for a 1.0 FTE (80 hours per pay period), Monday - Friday, 8am - 4:30pm CST
As an Outpatient CDI, you will play a critical role in creating a culture of best-in-class clinical documentation accuracy in support of building a model of care focused on quality and health outcomes
You will work closely with our Population Health, Clinical, and Compliance teams to participate in our Clinical Documentation Integrity program and leverage your clinical, coding, and documentation expertise to foster improvements in the overall quality, completeness, and compliance of clinical documentation
Outpatient CDI performs clinically based health record reviews to facilitate and obtain appropriate provider documentation for clinical conditions and procedures to reflect severity of illness, risk adjustment, accurate coding, accuracy of patient outcomes, and complexity of patient care
This includes accurate documentation to support the capture of Hierarchical Condition Categories (HCCs), ICD-10-CM specificity, and CPT/HCPCS codes in outpatient visits
Outpatient CDI review a variety of outpatient settings including, but not limited to provider offices, hospital-based clinics, ambulatory surgery, observations, and emergency departments
Through compliant query processes and education, clarifies incomplete, conflicting, ambiguous, and/or missing provider documentation
The Outpatient CDI work in collaboration with other CDI specialists, coders, quality, providers, and other members of the healthcare team to ensure accurate, high-quality clinical documentation to support MHealth Fairview initiatives
The Outpatient CDI functions as a resource and educates members of the patient care team, both formally and informally, regarding the impact of documentation on patient care, quality metrics, risk adjustment, and correct reimbursement
Adheres to departmental and organizational goals, objectives, standards of performance, policies, and procedures, continually ensuring quality documentation and regulatory compliance
In collaboration with the providers and staff, identifies first listed diagnosis, secondary diagnoses, pertinent HCCs, outpatient procedures, and documentation completeness in the outpatient/ambulatory setting
Facilitate appropriate clinical documentation through prospective, concurrent, and retrospective medical record review
Ensures accuracy, completeness, and quality of clinical information used for measuring and reporting physician and hospital outcomes
Performs thorough and timely medical record reviews to identify potential gaps or opportunities to facilitate improved provider documentation
Maintain competence related to HCC documentation requirements, ICD-10-CM code assignment, coding guidelines, conventions, and coding clinics
Demonstrates thorough understanding of various payment structures, fee schedules, and reimbursement methodologies in the outpatient setting, including physician encounters and how physician documentation translates into ICD-10-CM and HCC risk adjustment for claims submission to meet reporting requirements
Ensures clinical documentation accurately reflects the level of care rendered, severity of illness, risk of mortality, and supports clinical validation (in compliance with government and other regulations)
Recognizes opportunities for documentation improvement using strong critical-thinking skills and sound judgment in decision making, keeping integrity and compliance at the forefront of considerations in addition to outcomes, reimbursement, and regulatory requirements
Facilitates high-quality documentation by utilizing queries that are effective, clear, concise, and compliant in accordance with latest AHIMA/ACDIS Query Practice Brief and white paper guidance
Provides information and ongoing education, as necessary, to providers and staff on documentation issues, guidelines, and unanswered queries
Promotes compliance with CMS, Medicare documentation, and coding and billing regulations
Participates in the processes to assess and improve the services provided and compliance with regulatory requirements
Reports results assessment and improvement processes to the appropriate administrative levels
Collaborates with the Population Health Department to ensure documentation meets quality initiative standards used for measuring and reporting ACO and provider outcomes
Collects, analyzes, and submits timely, accurate and complete reports of clinical documentation information used for measuring and reporting ACO and Provider outcomes data
Participates in the education of new team members concerning clinical documentation integrity guidelines and processes
This may include providers, CDIs, coders, and other healthcare providers
Works with the Coding teams on any issues that arise concerning documentation, providers, and queries to enhance the concurrent process to enable prompt coding
May provide educational support in terms of clinical/coding or process at manager’s discretion and as need arises
Demonstrates willingness to learn and accepts feedback productively
Meets and maintains CDI quality, productivity, and query compliance standards per policy
Works independently; demonstrates effective time management and prioritization of tasks
Perform duties and conducts interpersonal relationships in a manner that promotes a team approach and collaborative work environment with physicians, CDI staff and coders
Assumes responsibility for professional development through participation at workshops, conferences, and/or in-services and maintains appropriate records of participation
Complies with and ensures adherence to HIPAA and Code of Conduct policies
Support and assist Coding staff during back-logs
Performs other job-related duties as assigned
Develops Strong Work Relationships:
Participates in work with peers and other departments to create an excellent understanding of workflows and interdependencies, and to identify and implement strategies to improve revenue cycle performance
Works collaboratively with vendors to assure performance expectations are being met as necessary
Represent Revenue Cycle and Fairview Health Services at industry forums to network and identify process improvement opportunities
Serves as a resource on revenue cycle issues and regulatory expectations
Creates strong collaborative partnerships and influence others across teams, groups and business boundaries to achieve real world problem solving
Job description
Overview:

We at M Health Fairview are looking for a Remote Outpatient Clinical Documentation Integrity (CDI) Specialist to join our team!

This is a fully remote position that is approved for a 1.0 FTE (80 hours per pay period), Monday - Friday, 8am - 4:30pm CST.

As an Outpatient CDI, you will play a critical role in creating a culture of best-in-class clinical documentation accuracy in support of building a model of care focused on quality and health outcomes. You will work closely with our Population Health, Clinical, and Compliance teams to participate in our Clinical Documentation Integrity program and leverage your clinical, coding, and documentation expertise to foster improvements in the overall quality, completeness, and compliance of clinical documentation.

Outpatient CDI performs clinically based health record reviews to facilitate and obtain appropriate provider documentation for clinical conditions and procedures to reflect severity of illness, risk adjustment, accurate coding, accuracy of patient outcomes, and complexity of patient care. This includes accurate documentation to support the capture of Hierarchical Condition Categories (HCCs), ICD-10-CM specificity, and CPT/HCPCS codes in outpatient visits. Outpatient CDI review a variety of outpatient settings including, but not limited to provider offices, hospital-based clinics, ambulatory surgery, observations, and emergency departments. Through compliant query processes and education, clarifies incomplete, conflicting, ambiguous, and/or missing provider documentation. The Outpatient CDI work in collaboration with other CDI specialists, coders, quality, providers, and other members of the healthcare team to ensure accurate, high-quality clinical documentation to support MHealth Fairview initiatives. The Outpatient CDI functions as a resource and educates members of the patient care team, both formally and informally, regarding the impact of documentation on patient care, quality metrics, risk adjustment, and correct reimbursement. Adheres to departmental and organizational goals, objectives, standards of performance, policies, and procedures, continually ensuring quality documentation and regulatory compliance.

Responsibilities/Job Description:

Job Expectations:
• In collaboration with the providers and staff, identifies first listed diagnosis, secondary diagnoses, pertinent HCCs, outpatient procedures, and documentation completeness in the outpatient/ambulatory setting.
• Facilitate appropriate clinical documentation through prospective, concurrent, and retrospective medical record review.
• Ensures accuracy, completeness, and quality of clinical information used for measuring and reporting physician and hospital outcomes.
• Performs thorough and timely medical record reviews to identify potential gaps or opportunities to facilitate improved provider documentation.
• Maintain competence related to HCC documentation requirements, ICD-10-CM code assignment, coding guidelines, conventions, and coding clinics.
• Demonstrates thorough understanding of various payment structures, fee schedules, and reimbursement methodologies in the outpatient setting, including physician encounters and how physician documentation translates into ICD-10-CM and HCC risk adjustment for claims submission to meet reporting requirements.
• Ensures clinical documentation accurately reflects the level of care rendered, severity of illness, risk of mortality, and supports clinical validation (in compliance with government and other regulations).
• Recognizes opportunities for documentation improvement using strong critical-thinking skills and sound judgment in decision making, keeping integrity and compliance at the forefront of considerations in addition to outcomes, reimbursement, and regulatory requirements.
• Facilitates high-quality documentation by utilizing queries that are effective, clear, concise, and compliant in accordance with latest AHIMA/ACDIS Query Practice Brief and white paper guidance.
• Provides information and ongoing education, as necessary, to providers and staff on documentation issues, guidelines, and unanswered queries.
• Promotes compliance with CMS, Medicare documentation, and coding and billing regulations.
• Participates in the processes to assess and improve the services provided and compliance with regulatory requirements. Reports results assessment and improvement processes to the appropriate administrative levels.
• Collaborates with the Population Health Department to ensure documentation meets quality initiative standards used for measuring and reporting ACO and provider outcomes.
• Collects, analyzes, and submits timely, accurate and complete reports of clinical documentation information used for measuring and reporting ACO and Provider outcomes data.
• Participates in the education of new team members concerning clinical documentation integrity guidelines and processes. This may include providers, CDIs, coders, and other healthcare providers.
• Works with the Coding teams on any issues that arise concerning documentation, providers, and queries to enhance the concurrent process to enable prompt coding.
• May provide educational support in terms of clinical/coding or process at manager’s discretion and as need arises.
• Demonstrates willingness to learn and accepts feedback productively.
• Meets and maintains CDI quality, productivity, and query compliance standards per policy.
• Works independently; demonstrates effective time management and prioritization of tasks.
• Perform duties and conducts interpersonal relationships in a manner that promotes a team approach and collaborative work environment with physicians, CDI staff and coders.
• Assumes responsibility for professional development through participation at workshops, conferences, and/or in-services and maintains appropriate records of participation.
• Complies with and ensures adherence to HIPAA and Code of Conduct policies.
• Support and assist Coding staff during back-logs.
• Performs other job-related duties as assigned

Develops Strong Work Relationships:
• Participates in work with peers and other departments to create an excellent understanding of workflows and interdependencies, and to identify and implement strategies to improve revenue cycle performance.
• Works collaboratively with vendors to assure performance expectations are being met as necessary.
• Represent Revenue Cycle and Fairview Health Services at industry forums to network and identify process improvement opportunities.
• Serves as a resource on revenue cycle issues and regulatory expectations.
• Creates strong collaborative partnerships and influence others across teams, groups and business boundaries to achieve real world problem solving

Qualifications:

Required Education
• Associate degree in HIM, or equivalent healthcare coding experience.

Required Experience
• At least 2-3 years coding experience required; or a combination of 1-2 years coding experience and HCC Capture, Risk Adjustment or Outpatient CDI experience.
• Demonstrated extensive critical-thinking skills, and understanding of disease processes, anatomy, pathophysiology, and disease management/treatment required.
• Demonstrated knowledge of current coding guidelines and methodologies: HCCs, ICD-10-CM coding guidelines, clinics, and conventions required

Required License/Certification:
• Outpatient or Professional Fee Coding: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Certified Coding Specialist - Professional (CCS-P), Certified Professional Coder - Hospital (CPC-H), Certified Clinical Documentation Specialist-Outpatient (CCDS-O), Certified Risk Adjustment Coder (CRC)

Additional Requirements:
• Proficiency with Microsoft Office (Teams, Excel, PowerPoint, Word, Outlook) required.
• Proficiency with electronic medical record (EMR) required. Epic preferred.
• Proficiency with coding technology systems preferred.
• Excellent written and verbal communication skills; ability to write concisely and effectively when communicating with providers.
• Expert knowledge of ICD-10 and CPT and related coding/abstracting rules and guidelines
• Expert knowledge of medical terminology, anatomy, physiology, and pathophysiology
• Expert knowledge of relationships of disease management, medications and ancillary test results on diagnoses assigned
• Proficiency with computer systems, including electronic health record
• Critical thinking and problem-solving skills
• Highly effective written and verbal communication skills
• Ability to prepare educational materials for coding staff and providers
• Ability to accept cultural differences

Preferred Education
• Bachelor’s degree in HIM or higher

Preferred Experience:
• 4-5 years of relevant coding experience; or a combination of 3+ years coding experience and HCC Capture, Risk Adjustment or Outpatient CDI experience.
• Prior clinical documentation integrity (CDI) experience

Preferred License/Certification/Registration
• Outpatient or Professional Fee Coding: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Certified Coding Specialist - Professional (CCS-P), Certified Professional Coder - Hospital (CPC-H), Certified Clinical Documentation Specialist-Outpatient (CCDS-O), Certified Risk Adjustment Coder (CRC