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Clinical Documentation Integrity Specialist (Cdis)

Company

Firsthand
Address , Remote
Employment type FULL_TIME
Salary $75,000 - $85,000 a year
Expires 2023-06-26
Posted at 1 year ago
Job Description
firsthand is changing the way individuals living with Serious Mental Illness (SMI) get care – by putting them at the center of everything we do. Our peer led model aims to build trust with these individuals, many of whom have been underserved, stigmatized, deprioritized and have very often lost trust in the systems intended to serve them. Our holistic approach includes partnering with our team of peer recovery specialists, licensed social workers and nurse practitioners, and focuses on meeting them where they are and walking with them side by side, as a trusted guide, partner, and first call, on their journeys’ to wellness.

Our aim is to not only improve lives, but also improve the economics for managed care plans and states responsible for providing care to this community. This enables us to build solutions that scale and, as a result, change the way our society supports those most impacted by SMI.

We are building a team of deeply passionate problem-solvers who are courageous enough to take on one of the country’s most challenging healthcare problems. Those who are up for the task will be rewarded with deeply mission-oriented workdays, mentorship from a similarly motivated team, and a supportive culture that prioritizes learning, creativity, and fun.

The Clinical Documentation Integrity Specialist (CDIS) is a key member of firsthand’s clinical documentation team. We are looking for a scrappy, detail-obsessed individual who will ensure accurate, comprehensive, and timely clinical documentation. The CDIS will enable the best care possible for our individuals by empowering: our care teams to plan appropriate care, our support teams to identify potential population health interventions, and more. This is a full-time, salaried, and virtual position.

As a Clinical Documentation Integrity Specialist (CDIS), you will:

  • Perform prospective, retrospective, and concurrent coding reviews based on evaluations of prior visit documentation, lab results, images, external medical records, payer claims data, and more
  • Support medical records requests when providers require additional information prior to addressing and diagnosing potential conditions
  • Work with team leadership to identify chronic condition prevalence trends by individuals’ demographics; identify and execute potential interventions, e.g., ongoing education to firsthand providers and the CDI team, ongoing monthly retrospective reviews of unaddressed suspects
  • Ensure accurate, timely, and comprehensive clinical documentation to support code capture, including querying providers when these clinical documentation standards are not met
  • Support pre-visit planning by communicating to firsthand providers individuals’ potential chronic conditions and care gaps with robust and appropriate evidence

You will be a good fit if you have:

  • Excellent written and verbal communication skills, especially to maintain working relationships with firsthand providers (APNs, NPs), other CDISs, Medical Records Specialists, and others
  • At least 3 years of risk adjustment-focused medical record review and ICD-10 coding experience, specifically using the Medicare HCC model, in multiple settings (e.g., inpatient, outpatient)
  • Ability to gain proficiency in and apply productivity tools, such as spreadsheets, Google Suite, and EHR systems
  • Alignment to firsthand’s mission, vision and values: Demonstrate respect, dignity, empathy, and professional conduct to both individuals that firsthand serves and firsthand team members
  • Certified Risk Adjustment Coder (CRC) from AAPC in good standing
  • Fluent knowledge of ICD-10 CM Official Guidelines for Coding and Reporting, and AHA/AMA/CMS coding resources, to support audit findings

The experience you bring to this role includes:

  • Exceptional interpersonal, written and verbal communication skills; proven ability to collaborate across multiple teams and engage in multiple perspectives to work toward a common goal
  • Demonstrated mastery of the Medicare HCC model, clinical coding guidelines/methodologies, and AHIMA/ACDIS ethical standards of coding; self-motivated to stay abreast of CMS rules and incorporate those changes into daily work (Bonus but not necessary: familiarity with Medicaid risk models, such as CDPS or ACG)
  • Self-starter with a high degree of drive, initiative, and follow through; comfortable and motivated to work in a fast-paced, ever-changing environment with a passion for problem solving
  • Proficiency in tracking down, leveraging, and reviewing high volumes of internal and external data (e.g., medical records) to support pre-visit planning and appropriate code capture
$75,000 - $85,000 a year
Clinical Documentation Integrity Specialist
firsthand Benefits:

For Full Time employees, our compensation package includes base, equity and a bonus potential. Our benefits include physical and mental health, dental, vision, 401(k) with a match, 16 weeks parental leave for either parent, flexible vacation, and a supportive culture.

We firmly believe that great candidates for this role may not meet 100% of the criteria listed in this posting. We encourage you to apply anyway - we look forward to getting to know you.

Unfortunately, we are not able to offer sponsorship at this time.