Responsibilities

• Perform high-level, secondary case reviews to ensure accurate and comprehensive provider documentation
• Perform CDI audits
• Assess documentation alignment with ICD-10-CM/PCS, MS-DRG/APR-DRG, and payer guidelines
• Identify missed or inappropriate diagnoses, procedures, CCs/MCCs, and severity of illness (SOI) / risk of mortality (ROM) opportunities
• Analyze audit findings and prepare detailed reports with trends, risks, and improvement opportunities
• Provide feedback and education to CDI specialists, coders, and clinical staff

Requirements

• CCDS or CDIP certification required
• Minimum of 3 years of CDI experience
• Thorough knowledge of official medical coding guidelines, CMS, and private payer regulations
• Experience performing CDI Audits and second level reviews
• Ability to communicate collaboratively with physicians and hospital staff

Pr...