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Clinical documentation improvement specialist vs medical coder

The differences between clinical documentation improvement specialists and medical coders can be seen in a few details. Each job has different responsibilities and duties. It typically takes 6-12 months to become both a clinical documentation improvement specialist and a medical coder. Additionally, a clinical documentation improvement specialist has an average salary of $64,797, which is higher than the $51,563 average annual salary of a medical coder.

The top three skills for a clinical documentation improvement specialist include patients, patient care and clinical documentation improvement. The most important skills for a medical coder are CPC, medical terminology, and ICD-10-CM.

Clinical documentation improvement specialist vs medical coder overview

Clinical Documentation Improvement SpecialistMedical Coder
Yearly salary$64,797$51,563
Hourly rate$31.15$24.79
Growth rate11%11%
Number of jobs66,13051,316
Job satisfaction--
Most common degreeBachelor's Degree, 44%Associate Degree, 37%
Average age4545
Years of experience1212

What does a clinical documentation improvement specialist do?

Clinical documentation improvement specialists are professionals who are involved in the clinical documentation improvement (CDI) program that incorporates the terminology needed to translate a patient's condition into precise codes. These specialists must investigate complex healthcare reimbursement information to ensure that appropriate documentation is provided for proper patient care. They must collaborate with physicians and medical record coding staff so that they facilitate the clinical documentation improvement process. Clinical documentation improvement specialists must also train members of the patient care team about the documentation guidelines for medical records.

What does a medical coder do?

A medical coder's role is to interpret and analyze a patient's medical record and translate particular details according to the universal medical alphanumeric code. Moreover, a medical coder is primarily responsible for ensuring that the translations are accurate, as this will play a vital factor in processing insurance and receiving treatments. Aside from accuracy, it is also crucial for a medical coder to coordinate with other hospital personnel at all times, especially when there inconsistencies in the records.

Clinical documentation improvement specialist vs medical coder salary

Clinical documentation improvement specialists and medical coders have different pay scales, as shown below.

Clinical Documentation Improvement SpecialistMedical Coder
Average salary$64,797$51,563
Salary rangeBetween $47,000 And $87,000Between $37,000 And $70,000
Highest paying CityMadera, CATrenton, NJ
Highest paying stateCaliforniaHawaii
Best paying companyNuance CommunicationsMeta
Best paying industryHealth CareHealth Care

Differences between clinical documentation improvement specialist and medical coder education

There are a few differences between a clinical documentation improvement specialist and a medical coder in terms of educational background:

Clinical Documentation Improvement SpecialistMedical Coder
Most common degreeBachelor's Degree, 44%Associate Degree, 37%
Most common majorNursingHealth Care Administration
Most common collegeDuke UniversityStanford University

Clinical documentation improvement specialist vs medical coder demographics

Here are the differences between clinical documentation improvement specialists' and medical coders' demographics:

Clinical Documentation Improvement SpecialistMedical Coder
Average age4545
Gender ratioMale, 15.2% Female, 84.8%Male, 13.2% Female, 86.8%
Race ratioBlack or African American, 9.5% Unknown, 4.2% Hispanic or Latino, 15.7% Asian, 8.9% White, 60.4% American Indian and Alaska Native, 1.3%Black or African American, 9.2% Unknown, 4.2% Hispanic or Latino, 16.2% Asian, 9.0% White, 60.1% American Indian and Alaska Native, 1.3%
LGBT Percentage9%9%

Differences between clinical documentation improvement specialist and medical coder duties and responsibilities

Clinical documentation improvement specialist example responsibilities.

  • Create documentation education classes to general surgery residents, increasing the leveling of reporting which lead to increase revenues.
  • Interact directly with physicians to query for more specific documentation and to provide documentation guidelines from ICD-9 and ICD-10 standards.
  • Prepare, maintain and update clinical documentation ensuring completeness and accuracy of services provide to the patients.
  • Assign the correct POA status.
  • Participate in the initiation of the CDIS program.
  • Train new employees on how to utilize radiology information systems.
    • Show more

Medical coder example responsibilities.

  • Manage all EDI relate communication with trading partners and assist to produce all operational documents for all end users.
  • Manage all aspects of AR including writing letters for medical necessity, claim denials, bundling issues and charge capture.
  • Manage health records while applying ICD-10 coding to update and process insurance claims for time and accuracy to various insurance companies.
  • Manage the outsourced transcription company.
  • Create documentation education classes to general surgery residents, increasing the leveling of reporting which lead to increase revenues.
  • Adhere to regulations with CPT-4, ICD-9-CM and HCPCS coding with medical terminology and effort meet all audit requirements.
    • Show more

Clinical documentation improvement specialist vs medical coder skills

Common clinical documentation improvement specialist skills
  • Patients, 18%
  • Patient Care, 13%
  • Clinical Documentation Improvement, 12%
  • CCDS, 8%
  • ICD-10, 7%
  • CCS, 6%
Common medical coder skills
  • CPC, 11%
  • Medical Terminology, 8%
  • ICD-10-CM, 7%
  • AHIMA, 7%
  • Patients, 7%
  • Clinical Documentation, 5%

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Updated January 8, 2025

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