CDI Specialist - Mortality & Quality Reviews

Omega Healthcare Solutions•Boca Raton, FL

2d•$45 - $50•Remote

About The Position

The CDI Specialist – Mortality & Quality Reviews conducts second-level clinical chart reviews to evaluate and refine clinical documentation impacting patient mortality outcomes. This role performs in-depth clinical analysis to identify documentation gaps, ensure accurate risk adjustment, and collaborates with client leadership and internal teams to support quality and mortality initiatives.

Requirements

Demonstrated ability to dissect complex medical records to isolate uncaptured secondary conditions, ambiguous principal diagnoses, or missing clinical indicators affecting risk adjustment.
Proven track record of maintaining high accuracy in secondary reviews, data abstraction, and case log management.
Self-directed ability to prioritize multiple review queues, balance efficiency with thoroughness, and meet tight reporting deadlines.
Strict adherence to HIPAA, PHI standards, and compliant physician querying practices in alignment with AHIMA/ACDIS guidelines.
Maintain courteous and professional working relationships with employees at all levels of the organization.
Bachelor’s degree in a healthcare field (e.g., nursing, health information management) or an equivalent combination of education and experience.
Minimum of 1 to 3 years of experience in Clinical Documentation Improvement (CDI), clinical quality, utilization management, case management, or nursing.
Strong clinical acumen, disease process understanding, and critical thinking skills.
Proficiency in Microsoft Excel for tracking review metrics, dynamic reporting, and data analysis.

Nice To Haves

Healthcare related clinical credential preferred.
3 to 5 years of dedicated Clinical Documentation Improvement (CDI) experience with advanced clinical review capabilities.
Demonstrated experience performing second-level clinical mortality reviews and clinical documentation root-cause analysis.
Hands-on experience with the Vizient mortality methodology and risk-adjustment modeling.
CCDS (Certified Clinical Documentation Specialist) and/or CDIP (Certified Documentation Integrity Practitioner).
Experience working with Epic and 3M/Solventum.

Responsibilities

Perform comprehensive second-level clinical mortality reviews to evaluate documentation accuracy, severity of illness (SOI), and risk of mortality (ROM).
Analyze clinical records to identify documentation opportunities, ambiguous clinical conditions, and missing diagnoses that directly influence mortality metrics.
Partner professionally with client leadership, active clinical teams, and cross-functional stakeholders.
Participate in client-facing discussions, case reviews, and presentation of findings as required.
Maintain clear, concise, and effective written and verbal communication across all internal team members and client personnel.
Manage multiple review workflows and assigned priorities simultaneously while maintaining high precision, data integrity, and strict attention to detail.
Analyze clinical records using risk-adjustment models (e.g., APR-DRG, MS-DRG, Vizient) to ensure accurate Severity of Illness (SOI) and Risk of Mortality (ROM) representation.
Track, evaluate, and analyze key mortality performance metrics, including Observed-to-Expected (O/E) Mortality ratios, query response rates, and agreement rates.
Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance.