Supervisor, Outpatient CDI (RN) - Remote

Outpatient Clinical Documentation Integrity Supervisor

The Outpatient Clinical Documentation Integrity (CDI) Supervisor leads the team that bridges the gap between the providers and coders/billers to clarify at-risk documentation to ensure accurate claim submission. This position will have some supervisory responsibilities as well as a portion of CDI workflow responsibilities. You will be accountable for managing a team of CDI specialists in support of the goals of the AdvantagePoint Health Alliance clinically integrated networks. CDI activities include reviewing patient medical records in the clinic setting to capture an accurate representation of the severity of illness, risk adjustment and facilitate proper coding. This role will focus on the attributed patients in the AdvantagePoint Health Alliance clinically integrated networks by performing pre-visit and pre-bill CDI review.

Manage and support a team of approximately 7 CDI and coding specialists

Possess subject matter expert in how proper provider documentation drives accurate coding of outpatient services and associated risk adjustment.

Demonstrate ability to build strong working relationships with Clinicians, Administrators, and Revenue Cycle colleagues.

Leverage strong communication skills to bridge interrelated concepts, business functions, and processes to deliver results through an Outpatient CDI program.

Understand various payment structures, fee schedules, and reimbursement methodologies in the outpatient setting and with physician encounters and how physician documentation translates into ICD-10-CM and HCC risk adjustment for claims submission to meet reporting requirements.

Deliver presentations educating physicians, group practices and administration.

Track, monitor, and report on case reviews/queries and document results achieved.

Prioritize and organize time and materials, balancing physician documentation and education needs with competing priorities and deadlines.

Position serves both employed and independent providers and clinics in our Clinically Integrated Networks.

Access to and / or works with sensitive and / or confidential information.

Exhibit a comprehensive understanding of healthcare regulatory and compliance (e.g., HIPAA). Skilled in the application of policies and procedures. Knowledge of Business Office Standards and Recommended Practices.

This Position is 100% Remote; can work from anywhere within the US.

KNOWLEDGE, SKILLS & ABILITIES: The requirements listed below are representative of the knowledge, skills and/or abilities required.

Education: This position requires a minimum of an Associate degree in a healthcare related program

Experience: A minimum of 5 years of experience in health care, nursing, business, or finance

License or Certification:

This position requires an applicable CDIS or HIM (coding) credentialing through ACDIS, AHIMA, and/or AAPC. Or, this position requires an RN licensure with three years of ICD-10 and/or CPT/HCPCS coding. Certified Clinical Documentation Specialist - Outpatient (CCDS-O) required within three years.

Skills and Abilities:

This position requires an understanding and knowledge of physician documentation requirements in a clinic setting to capture patients' acute and chronic conditions

ICD-10-CM Dx Coding experience

Ability to work with physicians and providers

Disciplined - ability to work on their own for the most part after training

Knowledge/awareness of HCCs or risk models

Ability to navigate in various electronic health records and utilize AI/NLP technologies

Positive attitude and team player

Equal opportunity and affirmative action employers and are looking for diversity in candidates for employment: Minority/Female/Disabled/Protected Veteran