Clinical Documentation Specialist, Risk Adjustment
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.
- 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
Cityblock values diversity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means.
We take into account an individual’s qualifications, skillset, and experience in determining final salary. This role is eligible for health insurance, life insurance, retirement benefits, participation in the company’s equity program, paid time off, including vacation and sick leave. The expected salary range for this position is $66,300 to $102,200. The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location.
Medical Clearance (for Member-Facing Roles):
You must complete Cityblock’s medical clearance requirements, which include, but may not be limited to, evidence of immunity to MMR, Hepatitis B, Varicella, and a TB screen, or have an approved medical or religious accommodation that precludes you from being vaccinated against these diseases.
Covid 19 Update - Please Read:
Cityblock requires those hired into this position to provide proof that they have received the COVID-19 vaccine. Any individuals subject to this requirement may submit for consideration a request to be exempted from the requirement (based on a valid religious or medical reason) on forms to be provided by Cityblock. Such requests will be subject to review and approval by the Company, and exemptions will be granted only if the Company can provide a reasonable accommodation in relation to the requested exemption. Note that approvals for reasonable accommodations are reviewed and approved on a case-by-case basis and availability of a reasonable accommodation is not guaranteed. This vaccination requirement is based, in part, on recently established government requirements. The requirement is also based on the safety and effectiveness of the vaccine in protecting against COVID-19, and our shared responsibility for the health and safety of members, colleagues, and community.