Clinical Documentation Improvement, CDI Specialist

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $70k - $80k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥📝 Medical Writer

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ConcertoCare

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2015

⚕️ Healthcare Insurance

🏥 Healthcare

🌍 Social Impact

Healthcare Insurance • Healthcare • Social Impact

ConcertoCare is a healthcare provider that specializes in delivering in-home medical care and support services for seniors. Their mission is to enable elderly patients to maintain independence and quality of life by providing coordinated health services right in their homes. With a focus on both medical and social needs, ConcertoCare offers a range of services, including primary care, transportation assistance, food support, and palliative care, particularly for those with complex care requirements. As a risk-bearing provider, ConcertoCare emphasizes advanced analytics and virtual care technology to enhance health outcomes for vulnerable populations, ensuring that each patient receives tailored care that addresses their unique challenges.

📋 Description

• Review paper-based medical charts to ensure HCC coding accuracy and substantiate encounter submissions. • Manage day-to-day provider compliance functions for Concerto Medicare membership. • Manage the risk adjustment provider Clinical Documentation Initiative process. • Educate providers on diagnosis specificity and clinical documentation. • Develop, present, and disseminate provider communications. • Ensure compliance with CMS Risk Adjustment HCC methodology rules, regulations, coding, and documentation guidelines. • Support development and implementation of a CDI risk adjustment and provider outreach program for ConcertoCare provider groups and payer partnerships. • Liaise with risk adjustment vendors on medical record review, provider alert compliance, and provider education. • Oversee assigned providers and markets and manage monthly provider education and engagement. • Identify improvement areas and monitor the clinical documentation provider engagement model. • Perform chart review and analyze provider activity around HCC conditions. • Generate queries for documentation requiring improvement and query providers to capture patient illness severity. • Assist in developing tools for provider education on documentation accuracy. • Communicate with the team, leadership, and internal departments to address issues and concerns.

🎯 Requirements

• Current coding certification required: CRC, CPC, CCS, CPC-H, or CCS-P; CPC-A is not accepted. • High school diploma required. • Bachelor's degree in Healthcare, Finance, or Business preferred. • Advanced knowledge of medical terminology, abbreviations, anatomy and physiology, major disease processes, and pharmacology. • Advanced knowledge of ICD-9-CM, ICD-10-CM, CPT, and HCPCS coding. • Knowledge of regulatory requirements, coding, and compliance standards. • Proficiency in Microsoft Office Suite, including Word, Excel, and Outlook. • Knowledge of writing and grammar, including report and correspondence formatting, spelling, word usage, grammar, punctuation, and sentence structure. • Keyboarding and ability to use software to produce correspondence, charts, spreadsheets, and other applicable information. • Analytical problem-solving orientation with a practical, results-oriented mindset. • Ability to manage multiple priorities while maintaining a positive attitude. • Unimpeachable integrity and maturity.

🏖️ Benefits

• Annual bonus • Full healthcare coverage • 401K with match • Other health, wellness, and financial benefits • Alcohol/Drug/Smoke-Free Workplace