Clinical Documentation Improvement Specialist

Specialised Part-Time Consulting OpportunityWe are sharing a specialised part-time consulting opportunity for experienced Clinical Documentation Integrity professionals with hands-on expertise in inpatient CDI, DRG coding and auditing, or clinical-documentation denial management.This role supports an advanced AI initiative focused on evaluating realistic inpatient CDI and coding workflows. Selected professionals will review AI-generated work against the clinical record, assess coding and documentation accuracy, identify unsupported diagnoses or incomplete actions, and determine whether appropriate CDI, query, coding, and DRG processes have been followed.Key ResponsibilitiesCDI & Inpatient Coding ReviewReview realistic inpatient CDI and coding tasks involving ICD-10-CM/PCS and MS-DRG workflowsEvaluate concurrent and retrospective pre-bill reviewsAssess working versus final DRG reconciliationConfirm coded diagnoses are appropriately supported by source documentationReview POA reporting, principal-diagnosis sequencing, and related coding decisionsClinical Validation & DRG EvaluationEvaluate CC/MCC impact, DRG movement, severity of illness, and risk-of-mortality implicationsAssess whether diagnoses are clinically supported by the complete patient recordApply relevant clinical criteria involving conditions such as AKI, sepsis, respiratory failure, malnutrition, and CKDIdentify unsupported, templated, or copy-forward diagnoses requiring further reviewEvaluate downstream effects of coding changes on DRG assignment and related outcomesQuery & Compliance ReviewAssess provider queries for compliance with AHIMA and ACDIS principlesIdentify leading or otherwise inappropriate query constructionDetermine when clarification requires a provider query and when existing documentation already provides sufficient specificityApply the principle that clinical indicators support a query rather than independent alteration of provider-documented diagnosesDistinguish appropriate code corrections, clinical-validation queries, clarification queries, and leave-as-is dispositionsWorkflow Completion & Evidence VerificationConfirm that required actions were fully completed and documentedVerify that queries were sent, holds were placed, codes were updated, and DRGs were recomputed where appropriateReview CDI notes, clinical documentation reviews, and supporting documentation for completenessIdentify unsupported claims involving laboratory results, previous encounters, provider responses, or grouper-generated DRG and reimbursement figuresWrite clear agree/disagree rationales explaining the accuracy and completeness of each reviewed attemptIdeal ProfileStrong candidates may have:At least 2 years of professional experience in inpatient hospital CDI, inpatient DRG coding or auditing, or clinical-documentation denial managementCurrent or recent hands-on experience with ICD-10-CM/PCS and MS-DRGsStrong knowledge of inpatient coding, DRG assignment, clinical validation, and documentation workflowsAbility to identify unsupported diagnoses, missed CC/MCC opportunities, inappropriate queries, and incomplete CDI processesExperience reading comprehensive clinical records including H&Ps, consults, progress notes, discharge summaries, laboratory results, and flowsheetsStrong professional judgment, attention to detail, and written communication skillsEducational BackgroundCCDS, CDIP, CCS, RHIA, RHIT, or comparable professional credentials are highly relevantRegistered nurses with substantial CDI experience may also be strong candidatesHospital coding, HIM, nursing, or related clinical documentation backgrounds are particularly relevantEquivalent professional experience involving intensive inpatient documentation and coding review may also be consideredNice to HaveExperience with Dolbey Fusion, 3M 360 Encompass, Nuance, Optum360, or comparable CAC/CDI platformsFamiliarity with professional DRG groupersExperience using Epic or comparable EHR systemsStrong knowledge of UHDDS reporting requirementsExperience with CDI-related denials or clinical-validation appealsFamiliarity with KDIGO criteria and other commonly applied clinical standardsExperience reviewing complex principal-diagnosis and sequencing scenariosPrior data annotation, structured review, or AI evaluation experienceWhy This OpportunityApply specialised CDI and inpatient coding expertise to advanced AI evaluationWork with realistic hospital documentation, coding, DRG, and query workflowsUse professional judgment to identify subtle documentation and clinical-validation errorsHelp improve the accuracy and reliability of AI systems operating in complex healthcare workflowsParticipate in flexible remote consulting work with competitive hourly compensationContract DetailsIndependent contractor roleFully remote with flexible schedulingCompetitive rates between $45–$115 per hour depending on expertise and project scopeWork may include CDI review, inpatient coding evaluation, DRG analysis, clinical validation, query assessment, and structured quality feedbackWeekly payments via Stripe or WiseProjects may be extended, shortened, or adjusted depending on scope and performanceWork will not involve access to confidential or proprietary information from any employer, client, or institutionAbout the PlatformThis opportunity is available through 24-MAG LLC. 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