Job Description:

About the Role

The Clinical Documentation Improvement (CDI) Specialist 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. The role will require working closely with our Burden of Illness, 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.

Responsibilities

• Review upcoming visits to validate persistent (chronic) conditions and raise potential suspect conditions for provider to assess

• Utilize various systems to find clinical support to assist in closing risk adjustment gaps

• Responsible for ensuring documentation rules, coding guidelines and company compliance guidelines are met

• Perform assessments of data to improve overall operations and identify opportunities for provider education and optimization

• Serve as a subject matter expert on HCC documentation requirements and ICD-10-CM coding guidelines (Medicaid documentation requirements understanding is a plus)

• Develop and support strong professional relationships with medical providers across the organization

Requirements for the Role

• HS Diploma

• Certification Required: CPC, CCS or equivalent

• 5+ years of overall experience; 3+ years of CDI-specific experience and 2+ years of outpatient HCC coding experience

• Knowledge of medical terminology, physiology, pharmacology, and disease processes and related procedures. Knowledge of risk adjustment (HCCs), guiding principles, and reimbursement methodology

• Proficiency with Google Suite and Microsoft Office, experience navigating EHR’s and various systems to complete assigned tasks

We take into account an individual’s qualifications, skillset, and experience in determining final salary. This role is eligible for health insurance, life insurance, retirement benefits, participation in the company’s equity program, paid time off, including vacation and sick leave. The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location. The expected salary range for this position is:

Cityblock values diversity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

Covid 19 Update - Please Read:

Cityblock requires those hired into this position to provide proof that they have received the COVID-19 vaccine. Any individuals subject to this requirement may submit for consideration a request to be exempted from the requirement (based on a valid religious or medical reason) on forms to be provided by Cityblock. Such requests will be subject to review and approval by the Company, and exemptions will be granted only if the Company can provide a reasonable accommodation in relation to the requested exemption. Note that approvals for reasonable accommodations are reviewed and approved on a case-by-case basis and availability of a reasonable accommodation is not guaranteed. This vaccination requirement is based, in part, on recently established government requirements. The requirement is also based on the safety and effectiveness of the vaccine in protecting against COVID-19, and our shared responsibility for the health and safety of members, colleagues, and community.

The COVID-19 pandemic has severely impacted the health and lives of people around the world, including the vulnerable populations Cityblock serves. As a healthcare provider, Cityblock holds ourselves to the highest standards when promoting the health and safety of those who we serve. Given that the COVID-19 vaccines are one of the most powerful tools to fight this disease and save lives, Cityblock is implementing a COVID-19 booster mandate for Washington, D.C. employees under the guidance of local/state mandates.

Medical Clearance (for Member-Facing Roles):

You must complete Cityblock’s medical clearance requirements, which include, but may not be limited to, evidence of immunity to MMR, Hepatitis B, Varicella, and a TB screen, or have an approved medical or religious accommodation that precludes you from being vaccinated against these diseases.

We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means.