CDI Specialist — Elevate Documentation & Reimbursement

RSD Human Resource Management Consultancy; Philippines; On-site; PHP 420,000 - 680,000; Full time

Job summary

RSD Human Resource Management Consultancy CDI role: The Clinical Documentation Improvement (CDI) Specialist reviews clinical documentation to ensure accuracy, completeness, and regulatory compliance. The goal is to enhance physician documentation for accurate coding, reimbursement, SOI, and ROM.

Responsibilities include identifying documentation gaps, collaborating with physicians and coders, initiating physician queries, educating providers on best practices, and tracking CDI metrics.

Qualifications

• RN or USRN with strong clinical background.
• 1+ years of CDI experience with medical coding or clinical documentation review.
• Strong knowledge of ICD10CM/PCS, DRGs, CC/MCCs, and clinical indicators.
• Familiarity with quality measures, SOI/ROM, and reimbursement methodologies.
• Excellent written and verbal communication skills.

Responsibilities

• Review inpatient and/or outpatient medical records to identify documentation gaps and opportunities for improvement.
• Collaborate with physicians, coders, and clinical staff to clarify diagnoses, procedures, and clinical indicators.
• Initiate and follow up on physician queries in accordance with compliant query guidelines, SOI, ROM, and quality metrics.
• Educate providers on documentation best practices and regulatory requirements.
• Track and report CDI metrics such as query response rates, CC/MCC capture, and case mix index (CMI).
• Ensure compliance with CMS, AHIMA, ACDIS, and organizational policies.
• Participate in audits, reviews, and performance improvement initiatives.

Skills

Clinical documentation

Medical coding

Communication skills

Regulatory compliance

Education

RN license or USRN

Job description

RSD Human Resource Management Consultancy CDI role: The Clinical Documentation Improvement (CDI) Specialist reviews clinical documentation to ensure accuracy, completeness, and regulatory compliance. The goal is to enhance physician documentation for accurate coding, reimbursement, SOI, and ROM.

Responsibilities include identifying documentation gaps, collaborating with physicians and coders, initiating physician queries, educating providers on best practices, and tracking CDI metrics.