Clinical Documentation Specialist, Risk Adjustment

#communityhealth #healthcare

About Us:

Cityblock Health is the first tech-driven provider for communities with complex needs—bringing better care to where it’s needed most, block by block. Founded in 2017 on the premise that “health is local” and based in Brooklyn, we are backed by Alphabet’s Sidewalk Labs along with some of the top healthcare investors in the country.

Our mission is to improve the health of underserved communities. Importantly, our solutions are designed specifically for Medicaid and lower-income Medicare beneficiaries, and we meet our members where they are, bringing care into the home and neighborhoods through our community-based care teams and Virtual Care offerings.

In close collaboration with community-based organizations, local providers, and leading health plans, we are reorganizing the health system to focus on what matters to our members. Equipped with world-class, custom care delivery technology, we deliver personalized primary care, behavioral health, and social services to deliver a radically better experience of care for every member and community we serve.

Over the next year, we’ll grow quickly to bring better care to many more members and their communities. To do this, we need people who, like us, believe that everyone should have good care for what matters to them, in their community. 

Our work is grounded in a belief in the power of a diverse community. To close gaps in care and advance equity in the communities we serve, we have to start with making our own team diverse and inclusive. Our ways of working are characterized by creativity, collaboration, and mutual learning that comes from bringing together a community from diverse backgrounds and perspectives. We strive to ensure that every person on the Cityblock team, and every Cityblock member, feels supported and included as a part of our community.

Our Values:

• Aim for Understanding
• Be All In
• Bring Your Whole Self
• Lean Into Discomfort
• Put Members First

About the Role:

As a Clinical Documentation Improvement (CDI) Specialist, you will play a critical role in creating a culture of best-in-class clinical documentation accuracy in support of building a model of care focused on quality and health outcomes. You will work closely with our Burden of Illness, Clinical, and Compliance teams to participate in our Clinical Documentation Integrity program and leverage your clinical, coding, and documentation expertise to foster improvements in the overall quality, completeness, and compliance of clinical documentation. 

• The Clinical Documentation Integrity (CDI) Specialist at Cityblock will be responsible for ensuring Cityblock Burden of Illness team members and providers meet coding rules, query compliance, and company compliance guidelines 
• The CDI specialist will also perform assessments of data to improve overall operations and identify opportunities for provider education and optimization 
• You will work closely with the Quality team to ensure that Quality measures are also captured accurately 
• You will serve as a subject matter expert on HCC documentation requirements and ICD-10-CM coding guidelines (Medicaid documentation requirements understanding is a plus) 
• You will query providers to ensure that appropriate documentation appears in the medical record
• Develop and support strong professional relationships with medical providers across the organization
• Conduct ongoing education and training for providers on proper documentation and coding
• Assist the Manager, CDI with analysis, trending, and presentation of audit / review findings, outcomes, and issues

Requirements for the Role:

• Must have 3+ years of CDI-specific experience and 2+ years of outpatient HCC coding experience 
• Ability to  frequently perform without supervision and  drive projects and problem statements 
• AAPC or AHIMA certified coder a must 
• Strong knowledge of medical terminology, physiology, pharmacology, and disease processes and related procedures
• Knowledge of risk adjustment (HCCs), guiding principles, and reimbursement methodology
• Ability to  flourish in fast-paced environments, work independently, and identify individual opportunities for success
• Must have great attention to detail, data-driven and tech-savvy
• Ability to demonstrate excellent written and verbal communication and critical thinking skills
• Strong ability to effectively build relationships and collaborate with coworkers and clinicians
• Stays abreast of industry coding changes and maintains all certifications as necessary

What We’d Like From You:

• A resume and/or LinkedIn profile <