About this role
Shape AI tools that strengthen clinical documentation accuracy, coding integrity, compliance, and revenue integrity. In this remote leadership role, you will apply CDI expertise across DRG optimization, HCC risk adjustment, physician queries, and documentation best practices to evaluate and improve AI-generated clinical content.
Key Responsibilities- Lead inpatient and/or outpatient CDI programs, including concurrent and retrospective review workflows.
- Evaluate AI-generated documentation improvement suggestions, physician queries, and coding recommendations for clinical accuracy and compliance.
- Review clinical documentation to ensure diagnoses, procedures, severity of illness, and risk of mortality are accurately captured.
- Develop and manage physician query processes that align with AHIMA and ACDIS guidelines.
- Track CDI performance indicators, including query response rates, CC/MCC capture rates, case mix index, and DRG accuracy.
- Partner with coding, compliance, and clinical teams to resolve documentation gaps and improve query processes.
- Educate physicians and clinical staff on documentation requirements and best practices.
- Maintain compliance with Official Coding Guidelines, CMS regulations, and payer-specific requirements.
- Annotate AI outputs and provide structured clinical feedback for AI training datasets.
- At least 5 years of clinical documentation integrity or improvement experience, including at least 2 years in a management or leadership role.
- Deep knowledge of MS-DRG methodology, CC/MCC hierarchies, and ICD-10-CM/PCS coding guidelines.
- Expertise in physician query management using AHIMA and ACDIS-compliant query standards.
- Strong clinical background and ability to interpret medical records and clinical documentation.
- Proficiency with CDI platforms such as 3M, Nuance, Optum360, or equivalent, along with EHR systems.
- Exceptional written and verbal English communication skills, close attention to detail, and the ability to critically assess clinical documentation and AI-generated outputs.
- Ability to work independently in a fully remote environment.
- CCDS or CDIP credential.
- Experience with HCC risk adjustment and outpatient CDI programs.
- RN, RHIA, CCS, or a similar clinical or coding credential.
- Familiarity with AI-assisted CDI tools, including Nuance DAX or 3M M*Modal, and evaluating AI-generated clinical content.
- Experience presenting CDI performance metrics to clinical and executive leadership.
- Remote, hourly engagement.
- $84 per hour.
- Contribute to advanced healthcare AI workflows focused on clinical documentation and revenue cycle management.
- Collaborate with an AI research organization on high-impact healthcare AI work.