CDI Support Specialist

Job Description

Job Description

Description:

Job Classification:

• This is an exempt position under the Fair Labor Standards Act (FLSA) and is not eligible for overtime pay.

Our Mission:

Our mission is to drive financial wellness in healthcare organizations so more patients can receive the care they need.

Our Vision:

Our vision is a future where we help healthcare organizations thrive in a complex ecosystem by clearing a path to financial health.

Our Culture:

We are committed to creating a workplace where every member feels valued, empowered, and inspired to contribute their best. Together we will foster a culture that promotes work-life balance and celebrates community engagement, personal achievements, milestones, and special occasions.

Values:

Integrity – We do what’s right, no matter what.

Innovation – We use a harmonious blend of data, tech, and a human-centric approach.

Compassion – We understand the stress of healthcare organizations and their patients.

Determination – Our mission is our guiding force.

Partnership – We build enduring relationships through listening, communication and accountability.

Dignity – We have significant pride in each other and our work.

Job Summary: The CDI Support Specialist is responsible for overseeing and continuously improving administrative and operational support processes within PC3’s Clinical Documentation Integrity (CDI) division. This role exercises independent judgment and discretion in analyzing administrative support workflows, developing process enhancements, and ensuring regulatory compliance across all CDI activities. The Specialist serves as a key liaison between the Chief CDI Officer, Executive Director, Consultant Specialists, Physician Advisors, and internal departments to optimize operational performance, ensure data integrity, and support organizational goals related to documentation accuracy and quality improvement. The position requires proactive management of complex, confidential information, and coordination with both internal and external stakeholders to drive operational excellence.

This position reports directly to the CDI Executive Director.

Supervisory Responsibilities:

This position has no direct supervisory responsibilities.

Duties/Responsibilities:

• Ensures accurate and timely workflows/documentation associated with the Daily Case Tracker, and CDI Denial processes.
• Works closely with all members of the CDI Division to provide support and efficiency.
• Helps to identify and streamline processes for the highest level of efficiency.
• Exercises independent judgement and discretion in coordinating program operations supporting strategic initiatives, ensuring regulatory compliance and optimizing workflow efficiency across CDI and related departments.
• Exercise discretion in handling sensitive information related to patient data, quality metrics and staff performance.
• Ensure adherence to confidentiality coding and documentation standards in all administrative processes.
• Maintains access to all client EMR’s.
• Interprets and applies company policies to ensure adherence to all internal and external compliance regulations.
• Works independently to navigate and prioritize multiple clients workloads on a daily basis.
• Monitors, analyzes and processes payor denial letters for relevance, patterns to ensure response process aligns.
• Exercises discretion and independent judgement in managing confidential information and determining communication and workflow priorities.
• Maintains patient/employee/organization confidentiality at all times.
• Other duties as assigned.

Requirements:

Required Knowledge/Skills/Abilities:

• Proficient computer skills.
• Strong knowledge of healthcare operations, compliance and medical documentation processes.
• Excellent communication, problem solving and organizational skills.
• Proficient in Microsoft Office applications.
• Strong interpersonal and organizational skills.
• Payor portals experience is preferred

Education and Experience:

• Associate’s degree in healthcare administration, business, or related field preferred. (or an equivalent combination of education and experience)
• Minimum of three (3) years’ experience in healthcare operations, medical coding or insurance authorization coordination.

Physical Requirements:

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at times.