CDI Analyst - Risk Adjustment

CDI Analyst -AdventHealth Well 65+

All the benefits and perks you need for you and your family:

• Benefits from Day One

• Paid Days Off from Day One

• Student Loan Repayment Program

• Career Development

Our promise to you:

Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Schedule: M-F

Shift: 8-5

Location: Remote

The role you'll contribute:

The Risk Adjustment CDI Analyst performs pre-visit and retrospective reviews of ambulatory clinical documentation to ensure accurate depiction of the true complexity of the patient for compliant documentation to support the capture or Hierarchical Condition Categories (HCC), ICD-10-CM accuracy and specificity. The role will work collaboratively Coding and Documentation Educators to communicate documentation and coding opportunities service-line specific requirements.

The value you'll bring to the team:

• Responsible for utilizing their deep knowledge and understanding of current CMS coding guidelines, conventions and AHA coding clinics to improve the overall quality and completeness of the patient medical record.

• Performs pre-visit and retrospective reviews of ambulatory clinical documentation to ensure accurate and compliant documentation to support the capture or Hierarchical Condition Categories (HCC), ICD-10-CM accuracy and specificity.

• Facilitates appropriate modifications to clinical documentation to accurately reflect patient severity of illness and risk through extensive interaction with Coding and Documentation Educator. With Director and Manager's guidance, collaborates with coding staff to develop standard coding guidelines, policies and procedures .

• Demonstrates knowledge of documentation requirements and coding guidelines that pertain to outpatient diagnosis coding.

• Meets and maintains productivity and accuracy metrics and standards, as defined.

• Works closely with healthcare providers, physicians, and other coding professionals to clarify documentation and ensure coding reflects the severity of illnesses and chronic conditions.

• Provides feedback to the Coding and Documentation Educator regarding documentation deficiencies to improve accuracy and completeness.

• Stays updated with changes with coding guidelines, regulations, and compliance standards to maintain accuracy and compliance with the coding process.

• Follows HIPAA protocol and comply with state and federal guidelines.

Qualifications
The expertise and experiences you'll need to succeed :

• Minimum qualifications :

• Minimum of four years of healthcare experience

• Minimum of four years' experience in HCC coding

• Experience with Medicare risk adjustment, Hierarchical Condition Categories (HCC), coding, billing, auditing and various healthcare payers.

EDUCATION AND EXPERIENCE PREFERRED:

• Prior medical record review experience

• S trong ambulatory background with a focus on diagnostic coding

LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED :

• One of the following CPC, CCS (Certified Professional Coder), CDIP, CCDS-O

LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:

• CRC, CCDS

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