Clinical Documentation Improvement Specialist - Risk Adjustment
Bluestone Physician Services delivers great outcomes by bringing exceptional care to patients living with complex, chronic conditions and disabilities. Our unique, robust model of care goes beyond primary care services — our multidisciplinary care teams collaborate with patients, their families and other healthcare providers to deliver care that is preventative, proactive and tailored to their unique needs.
Using an evidence-based approach focused on quality care management and data-driven medical decisions, Bluestone care teams collaborate to manage patients’ chronic conditions, address social determinants of health, manage transitions to and from inpatient settings, provide behavioral health support and more. Under our model of care, Bluestone patients experienced 21% fewer ER visits, 36% fewer hospitalizations and 41% fewer hospital readmissions compared to patients with similar conditions and complexities over the same time period.
Our care teams travel directly to patients who reside in Assisted Living, Memory Care and Group Home communities throughout Minnesota, Wisconsin and Florida and are supported by clinical operations and administrative colleagues who work remotely or at our corporate offices in Stillwater, Minnesota, and Tampa, Florida.
Our success is only possible through the hard work of our employees who bring our core values of Dedication, Excellence, Collaboration and Caring to life every day. Bluestone has been named to the Star Tribune's Top Workplace list for the 13th year in a row! Bluestone also achieved Top Workplace USA 2021-2025! In 2022, Bluestone Accountable Care Organization (ACO) was the best performing ACO in the country as measured by the overall savings per Medicare beneficiary.
Position Overview:
We are seeking a highly motivated and detail-oriented individual to join our team as a Clinical Documentation Improvement (CDI) Specialist. The primary responsibility of this role is to conduct thorough patient chart reviews to identify opportunities for providers to capture risk adjustment diagnostic codes accurately. The successful candidate will play a crucial role in ensuring proper documentation to support appropriate and accurate disease capture and documentation by Bluestone providers.
Schedule: Full time position, weekdays, regular business hours, no evenings, weekends or holidays.
Location: This remote role must be located in one of the Bluestone Markets (Minnesota, Wisconsin or Florida).
Salary: $75,000 - $90,000 annually. Salary will be commensurate with experience.
Responsibilities:
- Perform comprehensive reviews of patient charts to identify gaps in documentation and opportunities for risk adjustment coding improvement.
- Collaborate with Bluestone providers and other clinical staff to educate them on the importance of accurate documentation for risk adjustment purposes.
- Provide ongoing training and support to Bluestone providers to enhance their understanding of risk adjustment coding guidelines and documentation requirements.
- Offer guidance and feedback to providers to facilitate improved documentation practices and ensure compliance with coding standards.
- Act as a resource for clinical staff regarding coding inquiries and documentation best practices.
- Maintain accurate records of chart reviews, coding opportunities identified, and outcomes of provider education efforts.
- Stay current with updates and changes in risk adjustment coding guidelines and regulations.
- Assist in the development and implementation of CDI initiatives to optimize coding accuracy and capture disease burden among Bluestone’s patient population
- Bachelor's degree in Health Information Management, Nursing, or related field.
- Certified Risk Adjustment Coder (CRC) certification, Risk Adjustment Coding (RAC) or related risk certification required
- Minimum of 2 years of experience in healthcare coding, with a focus on Hierarchical Condition Category (HCC) coding and risk adjustment.
- Proficiency in reviewing and analyzing medical records for documentation deficiencies and coding opportunities.
- Strong understanding of ICD-10-CM coding guidelines, particularly as they relate to risk adjustment.
- Excellent communication skills with the ability to effectively interact with Bluestone providers and clinical staff.
- Demonstrated experience in providing education and training to Bluestone professionals.
- Detail-oriented with strong analytical and problem-solving skills.
- Ability to work independently and manage time effectively in a remote or part-time role.
- Knowledge of healthcare compliance regulations and privacy laws.
- Demonstrated compatibility with Bluestone’s mission and operating philosophies
- Demonstrated ability to read, write, speak, and understand the English language
Bluestone Benefits:
- Health Insurance
- Dental Insurance
- Vision Materials Insurance
- Company paid Life Insurance
- Company paid Short and Long-term Disability
- Health Savings Account (with employer contribution)
- Flexible Spending Account (FSA)
- Retirement plan with 4% matching contributions
- Eight (8) paid holidays for office closures plus two (2) floating holidays
- Three weeks (15 Days) Paid Time Off (PTO)
- Company sponsored laptop and computer accessories
