Clinical Documentation Integrity (CDI) Leader
New
United StatesContractManager
Salary84 USD per hour
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Job Details
- Languages
- English
- Experience
- 5+ years
- Required Skills
- EHR
Requirements
- 5+ years of experience in clinical documentation integrity or improvement.
- At least 2 years in a manager or leadership role.
- Deep knowledge of MS-DRG methodology, CC/MCC hierarchies, and ICD-10-CM/PCS coding guidelines.
- Expertise in physician query management per AHIMA and ACDIS compliant query standards.
- Strong clinical background and ability to interpret medical records.
- Proficiency with CDI software platforms (3M, Nuance, Optum360, or equivalent) and EHR systems.
- Exceptional written and verbal English communication skills.
- High attention to detail and ability to evaluate AI-generated outputs.
- Comfortable working independently in a fully remote environment.
- CCDS or CDIP credential (preferred).
- RN, RHIA, or CCS credential (preferred).
- Experience with HCC risk adjustment and outpatient CDI programs (preferred).
Responsibilities
- Lead clinical documentation integrity programs for inpatient and outpatient settings.
- Oversee concurrent and retrospective review workflows.
- Evaluate AI-generated clinical documentation improvement suggestions, physician queries, and coding recommendations.
- Ensure accurate capture of diagnoses, procedures, severity of illness, and risk of mortality.
- Develop and manage physician query processes in alignment with AHIMA and ACDIS guidelines.
- Monitor CDI program KPIs including query response rates, CC/MCC capture rates, case mix index, and DRG accuracy.
- Collaborate with coding, compliance, and clinical teams to address documentation gaps.
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