Physician Advisory Services Clinical Documentation Improvement Specialist

Job Description: The Physician Advisor Services – CDI Specialist is responsible for improving the accuracy, completeness, and integrity of clinical documentation to ensure the medical record accurately reflects the patient’s clinical status, supports optimal patient care, and fulfills regulatory, quality, and reimbursement requirements. Through concurrent and retrospective review, this role applies advanced clinical judgment and knowledge of documentation standards to identify clinical indicators, clarify diagnoses with providers, and ensure proper capture of severity of illness, risk of mortality, and risk adjustment variables. The CDI Specialist partners closely with Clinical Documentation Integrity (CDI), Coding, Physician Advisors, Care Management, Quality, and regulatory teams to strengthen documentation performance across assigned facilities. Please note that a video interview through Microsoft Teams will be required as well as potential onsite interviews and meetings. We are committed to offering flexible work options where approved and stated in the job posting. However, we are currently not considering candidates who reside or plan to reside in the following states: California, Connecticut, Hawaii, Illinois, Massachusetts, Minnesota, New York, Pennsylvania, Rhode Island, Vermont, Washington. Concurrent & Retrospective CDI Reviews · Performs comprehensive reviews of inpatient medical records to ensure documentation accurately reflects the patient’s clinical presentation, diagnoses, treatments, and outcomes. · Identifies opportunities to improve capture of SOI, ROM, HCC, CC/MCC, DRG accuracy, and risk adjustment elements. · Ensures clinical documentation supports the acuity represented in coding and reimbursement methodologies. Provider Engagement & Clinical Clarifications · Collaborates with physicians and advanced practice providers to clarify ambiguous, incomplete, or conflicting documentation. · Provides education on documentation best practices, clinical criteria, and regulatory expectations. · Utilizes compliant query practices according to industry standards. Clinical Validation & Evidence-Based Criteria Application · Applies Intermountain clinical program criteria, service line guidance, and national evidence-based clinical indicators to validate diagnoses. · Identifies documentation that does not meet clinical validation standards and engages providers appropriately. · Supports documentation requirements for quality programs, infection prevention, patient safety, and publicly reported measures. Collaboration With Coding, Physician Advisors, & Care Management · Works closely with coding professionals to ensure accurate DRG assignment and alignment of documentation with coded data. · Partners with Physician Advisors to review complex clinical scenarios, documentation gaps, and medical necessity considerations. · Collaborates with Care Management to supply patient data needed for Utilization Review, Conditions of Participation, and status determinations. Quality, Risk Adjustment, & Regulatory Requirements · Evaluates documentation for impacts on mortality metrics, PSI/HAC, infection prevention, VBP, CMS Star Ratings, and other publicly reported outcomes. · Ensures documentation supports both commercial and government payer requirements. · Understands national HCC, RAF, DRG, and prospective payment methodologies. Denials Prevention & Appeals Support · Identifies documentation gaps that may result in medical necessity or DRG-related denials. · Works with the Appeals Unit and Physician Advisors to support clinical appeal efforts and prevent payment denials. Data, Analytics & Reporting · Maintains CDI metrics including accuracy rates, clarification trends, compliance issues, and documentation outcomes. · Contributes to dashboards and analytics that inform CDI and PAS program priorities. · Supports data abstraction requirements for internal and external reporting. Skills · Hospital Care Experience · Clinical chart review · Regulatory Compliance · Regulatory Requirements · Quality Improvement Focus · Data Abstraction · Clinical expertise · Coding expertise · Publicly reported data requirements · Written and verbal communication Interpersonal relationships Minimum Qualifications Degree in a clinical field (e.g. RN, RRT, LCSW). Education must be obtained through an accredited institution. Degree will be verified. Three years of clinical experience in an adult acute care setting OR one year of experience as a Clinical Documentation Improvement Specialist in an adult acute care setting. Proficiency in Quality and Infection Prevention reporting Proficiency in Risk adjustment and Proactive Care Models Preferred Qualifications Experience with Microsoft Office products. Clinical experience in ICU, CCU, primary care, or intermediate care. Experience with Clinical Documentation Integrity. Knowledge of EMR systems. CCS, CIC, CCDS or CDIP Physical Requirements Ongoing need for employee to see and read information, labels, documents, monitors, identify equipment and supplies, and be able to assess customer needs. Frequent interactions with providers, colleagues, customers, patients/clients and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately. Manual dexterity of hands and fingers to manipulate complex and delicate supplies and equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc. Location: Peaks Regional Office Work City: Broomfield Work State: Colorado Scheduled Weekly Hours: 40 The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $42.66 - $65.82 We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged. Learn more about our comprehensive benefits package here. Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process. All positions subject to close without notice. Headquartered in Utah with locations in six primary states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 34 hospitals, 400+ clinics, a medical group of more than 4,800 employed physicians and advanced care providers, a health plan division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery. Join our world-class team and embark on a career filled with opportunities, strength, innovation, and fulfillment. To find out more about us, head to our career site here. Sign up for job alerts! Click ‘sign in’ at the top right corner, create a candidate account, and when we have opportunities that meet your interests, you will receive an email with the job details. Intermountain Health strives to make the application process accessible to all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact View phone number on click.appcast.io or email View email address on click.appcast.io. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. Introduce yourself to our Talent Acquisition team and we will get in touch if there is a role that seems like a good match. Intermountain Health’s PEAK program supports caregivers in the pursuit of their education goals and career aspirations by providing up-front tuition coverage paid directly to the academic institution. The program offers 100+ learning options to choose from, including undergraduate studies, high school diplomas, and professional skills and certificates. Caregivers are eligible to participate in PEAK on day 1 of employment. Learn more. The primary intent of this job description is to set a fair and equitable rate of pay for this classification. Only those key duties necessary for proper job evaluation and/or labor market analysis have been included. Other duties may be assigned by the supervisor. All positions subject to close without notice. Thanks for your interest in continuing your career with our team!