Clinical Documentation Integrity (CDI) Medical Records Technician

HYRE HARPER Co. • Memphis, TN

1d • $27 - $33 • Onsite

About The Position

The CDI Medical Records Technician plays a critical role in enhancing the quality and accuracy of clinical documentation within the Veterans Health Administration (VHA) system. This position is based onsite at the Lt. Col. Luke Weathers, Jr. VA Medical Center in Memphis, TN, a high -complexity, tertiary care teaching hospital serving over 206,000 veterans across Tennessee, Arkansas, and Mississippi. As a Medical Records Technician (MRT) specializing in Clinical Documentation Integrity, you will collaborate with healthcare providers, coding professionals, and clinical staff to ensure that medical records accurately reflect the patient’s clinical status, diagnoses, and treatment plans. Your work will directly impact coding accuracy, reimbursement, quality reporting, and patient care outcomes.

Requirements

• Bachelor’s degree preferred; Master’s degree optional
• Minimum of 2 years of recent CDI experience in trauma, teaching, or tertiary hospital settings
• Must hold current certification from one or more of the following: ACDIS (Association of Clinical Documentation Integrity Specialists): Certified Clinical Documentation Specialist (CCDS))
• AHIMA (American Health Information Management Association): Certified Documentation Integrity Practitioner (CDIP)
• AAPC (American Academy of Professional Coders): Certified Documentation Expert Outpatient (CDEO) certification or Certified Documentation Expert Inpatient (CDEI) certification
• Proficient in reviewing inpatient and outpatient documentation, applying ICD -10 -CM coding standards, and using SNOMED -CT terminology
• Conduct concurrent and retrospective reviews of medical records
• Collaborate with providers to clarify documentation
• Develop SOPs, workflows, and training materials
• Participate in reconciliation of CDI and coding discrepancies
• Educate staff on documentation standards and compliance
• Must meet all VA, CMS, and Joint Commission documentation guidelines
• Must provide proof of current immunizations and screenings (TB, MMR, Varicella, Tdap, Influenza, COVID -19)
• Must pass background check and credentialing
• Must maintain PHI access and NPI registration
• Must adhere to ACDIS Code of Ethics

Responsibilities

• Perform concurrent and retrospective reviews of inpatient and outpatient medical records to identify documentation gaps and opportunities for improvement.
• Initiate and manage provider queries to clarify ambiguous, incomplete, or conflicting documentation.
• Apply knowledge of ICD -10 -CM coding, SNOMED -CT terminology, and VHA documentation standards to support accurate coding and billing.
• Assist in the development and implementation of CDI workflows, SOPs, and training programs.
• Educate providers and staff on documentation best practices, compliance standards, and regulatory requirements.
• Participate in reconciliation processes to resolve discrepancies between CDI and final coded records.
• Support quality initiatives including mortality reviews, CMS core measures, and utilization management.
• Maintain compliance with VA, CMS, and Joint Commission documentation guidelines.

Benefits

• Multiple nationwide and regional options, including HMO, PPO, and HDHP plans, with access to 24/7 telemedicine and wellness programs.
• Preventive, basic, and major dental services, plus vision exams, frames, and contact lenses.
• Pre -tax savings for healthcare expenses.
• Confidential support for mental health, legal consultations, and work -life balance.
• 401(k) Retirement Plan with Employer Matching.
• Budgeting tools and financial planning support.
• Savings on mass transit and reimbursement for eligible adoption expenses.
• Access to on -demand courses and professional growth programs.
• Sick Time and PTO
• Holiday Pay
• Discounts on fitness, nutrition, travel, and childcare.
• Free wellness and professional development courses.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level