Clinical Documentation Integrity Coder (remote)

About Our Company

Vytalize Health is a leading value-based care platform. It helps independent physicians and practices stay ahead in a rapidly changing healthcare system by strengthening relationships with their patients through data-driven, holistic, and personalized care. Vytalize provides an all-in-one solution, including value-based incentives, smart technology, and a virtual clinic that enables independent practices to succeed in value-based care arrangements. Vytalize's care delivery model transforms the healthcare experience for more than 250,000+ Medicare beneficiaries across 36 states by helping them manage their chronic conditions in collaboration with their doctors.

 

About our Growth 

Vytalize Health has grown its patient base over 100% year-over-year and is now partnered with over 1,000 providers across 36-states. Our all-in-one, vertically integrated solution for value-based care delivery is responsible for $2 billion in medical spending. We are expanding into new markets while increasing the concentration of practices in existing ones.

Visit www.vytalizehealth.com for more information.

 

Why you will love working here

We are an employee first, mission driven company that cares deeply about solving challenges in the healthcare space. We are open, collaborative and want to enhance how physicians interact with, and treat their patients. Our rapid growth means that we value working together as a team. You will be recognized and appreciated for your curiosity, tenacity and ability to challenge the status quo; approaching problems with an optimistic attitude. We are a diverse team of physicians, technologists, MBAs, nurses, and operators. You will be making a massive impact on people’s lives and ultimately feel like you are doing your best work here at Vytalize.

 

Your opportunity

The CDI Specialist supports clinical documentation to ensure complete, accurate, and compliant coding for Medicare and Medicare Advantage beneficiaries. Proficient in ICD-10-CM coding and risk adjustment methodologies, you optimize coding integrity, conducting chart reviews specifically addressing the CMS-HCC model. This role emphasizes production coding with a focus on enhancing clinical documentation through compliant risk adjustment chart review programs (minimum 30 charts per day). 

As a CDI Specialist, you significantly contribute to ensuring accurate and compliant documentation, aligning beneficiaries’ health burden with risk scores for appropriate Medicare reimbursement. Your expertise in precision and excellence supports the organization's commitment to providing high-quality healthcare services.  

 

What you will do

Clinical Documentation Enhancement: 

• Validate and ensure the completeness, accuracy, and integrity of coded data. 
• Support and enhance clinical documentation to ensure comprehensive, accurate, and compliant coding for Medicare and Medicare Advantage beneficiaries. 

Coding Proficiency: 

• Demonstrate proficiency in ICD-10-CM coding, CPT codes, HCPCS codes, and risk adjustment methodologies to optimize coding integrity. 
• Comply with HIPAA laws and regulations. 

Chart Reviews: 

• Review and accurately code medical records and encounters for ICD-10 diagnoses and procedures codes related to Risk Adjustment and HCC coding guidelines. 

Production Coding: 

• Oriented towards production coding, with a primary emphasis on improving clinical documentation through effective risk adjustment coding. 
• Maintain productivity standards averaging 30 charts per day. 

Documentation Alignment: 

• Ensure documentation aligns with regulatory guidelines and standards, emphasizing precision in risk adjustment processes. 
• Stay up to date with the latest coding guidelines, rules, and regulations related to Risk Adjustment and HCC coding. 

Contribution to Accuracy: 

• Contribute significantly to accurate and compliant documentation, aligning beneficiaries’ health burden with risk scores for appropriate Medicare reimbursement. 

Quality Assurance: 

• Ensure exemplary attention to detail and completeness, ensuring coding is consistent with ICD-10-CM, CMS-HCC, and other relevant coding guidelines. 
• Uphold a commitment to precision and excellence, maintaining at least a 95% coding accuracy rate. 

EHR Knowledge and Proficiency: 

• Demonstrate knowledge and expertise in various Electronic Health Record (EHR) systems to opti