Remote | CDI Specialist — $45–$115/hour

24-Mag•New York, NY

18h•$45 - $115•Remote

About The Position

We 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.

Requirements

At least 2 years of professional experience in inpatient hospital CDI, inpatient DRG coding or auditing, or clinical-documentation denial management
Current or recent hands-on experience with ICD-10-CM/PCS and MS-DRGs
Strong knowledge of inpatient coding, DRG assignment, clinical validation, and documentation workflows
Ability to identify unsupported diagnoses, missed CC/MCC opportunities, inappropriate queries, and incomplete CDI processes
Experience reading comprehensive clinical records including H&Ps, consults, progress notes, discharge summaries, laboratory results, and flowsheets
Strong professional judgment, attention to detail, and written communication skills

Nice To Haves

Experience with Dolbey Fusion, 3M 360 Encompass, Nuance, Optum360, or comparable CAC/CDI platforms
Familiarity with professional DRG groupers
Experience using Epic or comparable EHR systems
Strong knowledge of UHDDS reporting requirements
Experience with CDI-related denials or clinical-validation appeals
Familiarity with KDIGO criteria and other commonly applied clinical standards
Experience reviewing complex principal-diagnosis and sequencing scenarios
Prior data annotation, structured review, or AI evaluation experience

Responsibilities

Review realistic inpatient CDI and coding tasks involving ICD-10-CM/PCS and MS-DRG workflows
Evaluate concurrent and retrospective pre-bill reviews
Assess working versus final DRG reconciliation
Confirm coded diagnoses are appropriately supported by source documentation
Review POA reporting, principal-diagnosis sequencing, and related coding decisions
Evaluate CC/MCC impact, DRG movement, severity of illness, and risk-of-mortality implications
Assess whether diagnoses are clinically supported by the complete patient record
Apply relevant clinical criteria involving conditions such as AKI, sepsis, respiratory failure, malnutrition, and CKD
Identify unsupported, templated, or copy-forward diagnoses requiring further review
Evaluate downstream effects of coding changes on DRG assignment and related outcomes
Assess provider queries for compliance with AHIMA and ACDIS principles
Identify leading or otherwise inappropriate query construction
Determine when clarification requires a provider query and when existing documentation already provides sufficient specificity
Apply the principle that clinical indicators support a query rather than independent alteration of provider-documented diagnoses
Distinguish appropriate code corrections, clinical-validation queries, clarification queries, and leave-as-is dispositions
Confirm that required actions were fully completed and documented
Verify that queries were sent, holds were placed, codes were updated, and DRGs were recomputed where appropriate
Review CDI notes, clinical documentation reviews, and supporting documentation for completeness
Identify unsupported claims involving laboratory results, previous encounters, provider responses, or grouper-generated DRG and reimbursement figures
Write clear agree/disagree rationales explaining the accuracy and completeness of each reviewed attempt