CDI Specialist, Outpatient

Job Summary The Outpatient Clinical Documentation Integrity (CDI) Specialist supports accurate, complete, and compliant provider documentation in ambulatory settings. The role focuses on chronic condition capture, risk adjustment accuracy, quality reporting, and provider education to ensure documentation reflects the true clinical complexity of the patient population. Essential Duties and Responsibilities Review outpatient encounters to assess documentation accuracy and completeness. Identify opportunities for improved documentation related to chronic conditions, risk adjustment, quality measures, and medical necessity. Provide compliant documentation clarification via query and feedback to providers through approved communication channels. Support accurate problem list management and ongoing condition validation. Collaborate with coding, quality, compliance, and revenue cycle teams as needed. Track and report CDI interventions, trends, and outcomes. Participate in provider education and training initiatives. Stay current on outpatient coding, risk adjustment, and regulatory guidance. Ensure compliance with CMS, payer, and organizational documentation and billing requirements. Identify potential compliance risks including overcoding, undercoding, missing or unsupported diagnoses. Apply knowledge of HCCs, risk adjustment, quality measures, and outpatient reimbursement methodologies as applicable. Knowledge, Skills & Abilities Strong clinical and analytical judgment. Professional communication style. Excellent written documentation skills. Ability to work independently in a fast‑paced environment. Proficiency in Microsoft Office applications. Qualifications Active coding credential such as RHIA, RHIT, CPC, COC, CCS-O, CCS, CDEO, CCDS, CDIP or CCDS-O. 3+ years of outpatient coding, risk adjustment, and outpatient CDI experience. Strong understanding of ICD‑10‑CM outpatient coding, Medicare Advantage HCCs, and outpatient E/M documentation requirements. Experience working in an ambulatory EHR (Epic, Cerner, or similar). Physical Demands Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The role requires regular eye‑hand coordination, manual dexterity, and the ability to perform work at a computer terminal for 6‑8 hours a day. Attendance for prolonged periods of sitting, occasional lifting up to 20 lbs, and handling of elevated stress during busy periods are expected. This is a Remote Position This role is fully remote. Candidates may work from any U.S. location that complies with local regulations. #J-18808-Ljbffr