Evergreen Nephrology is hiring a Clinical Documentation Improvement Partner. In this role, you will partner with physician offices to translate healthcare documentation into standardized codes, ensuring accurate coding and billing. You will serve as a subject matter expert, collaborating directly with providers to support compliant, high-quality documentation.
What You'll Do
- Accurately code diagnoses based on documented information, ensuring compliance with regulatory requirements.
- Ensure documentation supports appropriate levels of care and severity of illness when applying ICD-10, CPT, and other relevant codes.
- Maintain a 95% productivity rate.
- Communicate with physicians and other healthcare providers to clarify documentation.
- Issue compliant queries to providers when documentation appears ambiguous, incomplete, or inconsistent.
- Stay updated on current coding guidelines, clinical protocols, and regulatory changes.
- Assist in improving clinical documentation quality to support initiatives like HEDIS and CMS performance metrics.
- Participate in performance improvement projects aimed at enhancing documentation practices.
- Conduct audits of medical records to identify documentation trends.
- Provide ongoing education to clinical staff and coders on best practices in documentation, coding, and compliance.
- Develop training programs to address documentation deficiencies.
- Collaborate with departments such as compliance, revenue cycle, and quality management to optimize the documentation improvement process.
What We're Looking For
- A high school diploma, GED, or suitable equivalent.
- 2+ years recent outpatient medical coding experience.
- Must possess one of the following credentials: CPC, CRC, CCS, or similar.
- Strong knowledge of ICD-10-CM, Category II and CPT coding.
- Proficiency in medical terminology, anatomy, and physiology.
- Familiarity with healthcare laws, regulations, and applicable guidance such as Medicare, Medicaid, HEDIS, and CMS performance measures.
- Knowledge of risk adjustment methodology and Hierarchical Condition Categories (HCC).
- Ability to analyze complex medical records, identify documentation gaps, and determine appropriate queries.
- Strong written and verbal communication skills.
- Meticulous attention to detail ensuring a high level of accuracy.
- Ability to identify discrepancies in clinical documentation and partner with providers to resolve issues efficiently.
- Familiarity with electronic health records (EHR), CDI software, and healthcare documentation systems.
- The tenacity required to drive initiatives forward and overcome obstacles.
- Intermediate skills with MS Office Suite, including Outlook and Teams.
- Ability to work effectively in a primarily remote environment with specific internet speed requirements.
Nice to Have
- An Associate’s or Bachelor‘s Degree in Nursing (BSN/ASN), Health Information Management (HIM), or related healthcare field.
- HCC Coding experience.
Benefits & Compensation
- Compensation: $28.00 hourly to $35.00 hourly
- Paid time off starting at 4 weeks for full-time employees.
- 12 paid holidays per year.
- Medical, dental, vision and life insurance, including an HSA with employer match.
- Reimbursement for continuing medical education for eligible roles.
- A 401(k) program where Evergreen matches up to 4% of contributions.
- Paid parental leave.
- A robust training and development program that starts with onboarding and continues throughout your career.
Work Mode
This role follows a hybrid work model.
Evergreen Nephrology is an equal opportunity employer. Applicants will not be discriminated against because of race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, citizenship status, disability, ancestry, marital status, veteran status, medical condition or any other protected category under local, state or federal laws.
