Clinical Documentation Specialist - Risk Adjustment at Cityblock Health
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 the Clinical Documentation Specialist - Risk Adjustment, 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 Value Services, Clinical, and Compliance teams to leverage your clinical, coding, and documentation expertise to foster improvements in the overall quality, completeness, and compliance of clinical documentation.
- Serve as the subject matter expert on HCC documentation requirements and ICD-10-CM coding guidelines (CDPS documentation requirement understanding a plus)
- Conduct coding review on all provider documentation to assign the correct ICD-10 codes and ensure all documentation is accurate, precise, and adherent to CMS guidelines
- Query providers to ensure that appropriate documentation appears in the medical record
- Maintain log of all documentation audits / reviews and conduct ongoing follow up activities and communication for uncompleted or unanswered queries
- Maintain professional communication with provider teams
- Assist with analysis, trending, and presentation of audit / review findings, outcomes, and issues
- Ensure adherence to Cityblock’s coding guidelines and any necessary updates are shared across the teams.
- Develop a foundational understanding of existing EMRs and processes to surface risk opportunities
- Comply with all legal requirements regarding coding procedures and practices
Requirements for the Role:
- You have 5+ years of overall experience, and 3+ years of outpatient risk adjustment coding specific experience or CDI equivalent
- Bachelor’s degree in Nursing, Health Information Management or other clinical degree preferred; however, an equivalent combination of education and experience that provides proficiency in the areas of responsibility, may be substituted for the stated education and experience requirements
- Certified Risk Adjustment Coder, CRC required and Certified Clinical Documentation Specialist CCDS certifications preferred
- Knowledge of medical terminology, physiology, pharmacology, and disease processes and related procedures
- Knowledge of risk adjustment (HCCs), guiding principles, and reimbursement methodology
- You flourish in fast-paced environments, work independently, and can identify your own opportunities for success
- You have great attention to detail, are data-driven, and is tech-savvy
- Excellent written and verbal communication skills and critical thinking skills
- Strong ability to effectively build relationships and collaborate with coworkers and clinicians
How We Define Success:
- Ensures all reviews are all in accordance with CMS rules and regulations
- Maintain accuracy and number of charts reviewed per hour in line with performance metrics set for Coding program (e.g., chart review rate, )
- Stays abreast of industry coding changes and maintains certification hours as necessary.
What We’d Like From You:
- A resume and/or LinkedIn profile
- A short cover letter, please!
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.