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Clinical Documentation Integrity Specialist/Educator, Remote

Aledade

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Santa Maria, CA, USA

Posted on Saturday, April 22, 2023

We are currently recruiting a Clinical Documentation Integrity Specialist/Educator (CDIS/E) to support clinical documentation integrity and coding within practices participating in value-based contracts. This position is critical to our practices’ ability to provide better care to Medicare beneficiaries and the CDIS/E is expected to be an exemplar of regulatory compliance. The CDIS/E will lead field and provider education and training related to complete and accurate diagnostic documentation and coding, in accordance with ICD-10 CM coding guidelines, internal protocols and CMS and payer guidelines. The CDIS/E will develop and deliver tailored education at the national, market, practice, and individual provider-level; complete end-to-end workflow assessment and optimization; and perform chart reviews to identify specific opportunities for improved accuracy. The CDIS/E must be detail-oriented, service-minded, possess strong verbal and written communication skills, and be fluent in (or willing and able to master) Google Suite tools.

There will be opportunity to travel periodically to practices as well as engage in remote work. Initial, onsite training is provided.

We are looking for individuals who genuinely believe that Aledade’s model of physician-led ACOs can improve quality and lower cost. This position will work remotely within the USA and includes periodic travel to Aledade’s Headquarters in Bethesda, MD and assigned markets.

Responsibilities:

Develop and implement action plans to improve the completeness and accuracy of clinical documentation and diagnosis coding
Create and deliver internal and external-facing education and training on clinical documentation and diagnosis coding
Advise Aledade leaders on clinical documentation and coding best practices
Evaluate and optimize end-to-end practice clinical documentation and coding workflows
Perform chart reviews to identify opportunities for better accuracy in clinical documentation and coding
Partner with internal stakeholders to improve reporting and analytics tools to drive improvements in the accuracy and completeness of clinical documentation and diagnosis coding
Work directly with Aledade practices and providers on continuous improvement of complete and accurate documentation and diagnosis coding
Facilitate clinical documentation and coding communication amongst key internal and external stakeholders
Provide guidance to field staff and practices regarding general documentation and coding best practices and risk adjustment
Support performance in value-based contracts

Required Education, Skills, and Experience:

Bachelor’s degree in a healthcare related field or equivalent work experience required
Current certification as a Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent
3+ years of recent, relevant work experience in CDI or 5+ years as a risk adjustment auditor
Thorough understanding of medical coding guidelines and regulations including compliance, reimbursement, and the impact of diagnosis documentation on risk adjustment payment models
Subject matter expertise on the CMS HCC Risk Adjustment program, methodology, and impact to value-based contracts
Ability to identify and communicate opportunities to improve documentation and diagnosis capture for accurate risk adjustment coding
Experience working directly with physician practices and individual providers to achieve demonstrable improvement in increasing the accuracy and completeness of documentation and diagnosis coding

Key Characteristics of the Successful Candidate:

Successful track record in CDI through previous experience
Strong understanding of value-based care principles, particularly as they relate to the impact of clinical documentation and coding on risk adjustment payment models in value-based contracts
Solution-oriented individual who can execute tactical continuous quality improvement work to deliver results in value-based contracts
Excellent communicator who can articulate the impact of documentation and diagnosis initiatives to Aledade ACO member practices and their key staff (e.g., office managers, practice billers, etc.), and internally within the company.
Ability to work collaboratively across Aledade clinical and non-clinical teams to gain buy-in and implement key documentation improvement initiatives
References demonstrating high degree of integrity and professional accountability

Required Training:

Must be able and willing to attend on-site training at the clinic in Santa Maria, CA otherwise this position is fully remote

Who We Are:

Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of payers, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives, and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.

What Does This Mean for You?

At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.

In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:

Flexible work schedules and the ability to work remotely are available for many roles

Health, dental and vision insurance paid up to 80% for employees, dependents, and domestic partners Robust time off plan 21 days of PTO in your first year 2 Paid Volunteer Days & 11 paid holidays

12 weeks paid Parental Leave for all new parents

6 weeks paid sabbatical after 6 years of service

Educational Assistant Program & Clinical Employee Reimbursement Program

401(K) with up to 4% match

Stock options

And much more!

At Aledade, we don’t just accept differences, we celebrate them! We strive to attract, develop, and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance, and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.

Privacy Policy: By applying for this job, you agree to Aledade's Applicant Privacy Policy available at https://www.aledade.com/privacy-policy-applicants

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