South Carolina Licensed Outpatient CDI Specialist

Job Summary

To enhance clinical documentation accuracy and compliance, the full-time South Carolina Licensed Outpatient CDI Specialist will conduct concurrent reviews of medical records, collaborate with healthcare providers on documentation improvement, and ensure accurate outpatient HCC coding while working in a hybrid environment.

Key Responsibilities

• Conduct concurrent reviews of medical records to ensure comprehensive documentation of patient severity and medical necessity
• Collaborate with healthcare providers to identify and address documentation gaps, ensuring compliance with coding guidelines
• Accurately assign ICD-10-CM and CPT codes for various outpatient encounters, maintaining a coding accuracy rate of 95% or higher

Required Qualifications

• Active licensure as a Registered Nurse in South Carolina or a compact state
• Minimum of three years of clinical nursing experience or experience in CDI or coding fields
• Certification in coding or clinical documentation improvement (e.g., CCDS, CDIP, CPC) required within the first year of employment
• Experience with outpatient Hierarchical Condition Category (HCC) coding preferred
• Bachelor's degree in nursing from an accredited institution preferred