Clinical documentation improvement specialist vs reimbursement specialist

The differences between clinical documentation improvement specialists and reimbursement specialists 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 reimbursement specialist. Additionally, a clinical documentation improvement specialist has an average salary of $64,797, which is higher than the $38,273 average annual salary of a reimbursement specialist.

The top three skills for a clinical documentation improvement specialist include patients, patient care and clinical documentation improvement. The most important skills for a reimbursement specialist are patients, customer service, and appeals.

Clinical documentation improvement specialist vs reimbursement specialist overview

	Clinical Documentation Improvement Specialist	Reimbursement Specialist
Yearly salary	$64,797	$38,273
Hourly rate	$31.15	$18.40
Growth rate	11%	11%
Number of jobs	66,130	32,292
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 44%	Bachelor's Degree, 40%
Average age	45	45
Years of experience	12	12

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 reimbursement specialist do?

A reimbursement specialist is responsible for analyzing insurance documents, processing reimbursement claims, and releasing accurate billing statements for insurance claims. Reimbursement specialists must have excellent analytical skills, especially on performing clerical tasks to evaluate insurance cases, investigate cases, and update the account information of the clients on the database. They should also have impeccable communication skills and understanding of the insurance processes to be able to coordinate with the clients, explaining the procedures of their claims accurately, and coordinate with the insurance management to improve the claims processes.

Clinical documentation improvement specialist vs reimbursement specialist salary

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

	Clinical Documentation Improvement Specialist	Reimbursement Specialist
Average salary	$64,797	$38,273
Salary range	Between $47,000 And $87,000	Between $29,000 And $49,000
Highest paying City	Madera, CA	Lynchburg, VA
Highest paying state	California	Virginia
Best paying company	Nuance Communications	Novartis
Best paying industry	Health Care	Pharmaceutical

Differences between clinical documentation improvement specialist and reimbursement specialist education

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

	Clinical Documentation Improvement Specialist	Reimbursement Specialist
Most common degree	Bachelor's Degree, 44%	Bachelor's Degree, 40%
Most common major	Nursing	Business
Most common college	Duke University	University of Pennsylvania

Clinical documentation improvement specialist vs reimbursement specialist demographics

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

	Clinical Documentation Improvement Specialist	Reimbursement Specialist
Average age	45	45
Gender ratio	Male, 15.2% Female, 84.8%	Male, 15.2% Female, 84.8%
Race ratio	Black 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, 9.8% Unknown, 4.2% Hispanic or Latino, 16.9% Asian, 8.1% White, 59.8% American Indian and Alaska Native, 1.3%
LGBT Percentage	9%	9%

Differences between clinical documentation improvement specialist and reimbursement specialist 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.

Reimbursement specialist example responsibilities.

Manage the EDI clearinghouse rejections.
Process department payroll, order supplies, and manage petty-cash funds.
Manage use of various systems, such as MEDITECH, Cerner, WebNow, and yield-base follow-up tool.
Manage cases by aggressively directing the litigation process.
Negotiate fee structure for manage care contracts on acute and rehabilitation facilities.
Research medical coding ICD-9, ICD-10, HCPCS and CPT-4 to let client know the outcome of medical claim.

Clinical documentation improvement specialist vs reimbursement specialist skills

Common clinical documentation improvement specialist skills

Patients, 18%
Patient Care, 13%
Clinical Documentation Improvement, 12%
CCDS, 8%
ICD-10, 7%
CCS, 6%

Common reimbursement specialist skills

Patients, 20%
Customer Service, 9%
Appeals, 6%
CPT, 5%
Medicare, 4%
Medicaid, 4%

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Clinical Documentation Improvement Specialist
Clinical Documentation Improvement Specialist vs Reimbursement Specialist

Updated January 8, 2025

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