Clinical Documentation Improvement (CDI) Specialist

RSD Human Resource Management Consultancy; Pasig; On-site; PHP 320,000 - 520,000; Full time

Benefits offered by this job

Performance Bonus

Health Insurance

Life Insurance

HMO

Job Training

Job summary

RSD Human Resource Management Consultancy is seeking a Clinical Documentation Improvement (CDI) Specialist in Pasig for hybrid work. The role emphasizes reviewing documentation to ensure accuracy and regulatory compliance, with a focus on ICD‑10‑CM/PCS coding, DRG assignment, and SOI/ROM metrics.

The ideal candidate is a Registered Nurse with CDI experience and strong communication skills, prepared to collaborate with clinicians and coders to improve documentation quality.

Qualifications

• RN/USRN with strong clinical background and CDI exposure.
• Experience with medical coding or clinical documentation review.
• Knowledge of ICD-10-CM/PCS, DRGs, CC/MCCs and quality measures.
• Excellent written and verbal communication skills.

Responsibilities

• Review inpatient and/or outpatient records to identify documentation gaps and improvement opportunities.
• Collaborate with physicians, coders, and staff to clarify diagnoses and indicators.
• Initiate and follow up on physician queries in line with compliant guidelines.
• Ensure docs support accurate ICD-10-CM/PCS coding, DRG assignment, SOI/ROM metrics.
• Educate providers on documentation best practices and regulatory requirements.
• Track and report CDI metrics such as query response and CMI.

Skills

RN/USRN

CDI experience

ICD-10/PCS knowledge

DRG & CC/MCC knowledge

Communication skills

Education

Bachelor's degree in Nursing

Job description

Clinical Documentation Improvement (CDI) Specialist

RSD Human Resource Management Consultancy

Hybrid - Pasig 1-3 Yrs Exp Bachelor Full-time

Job Description

Employee Recognition and Rewards

Performance Bonus

Government Mandated Benefits

Insurance Health & Wellness

Health Insurance, Life Insurance, HMO

Professional Development

Job Training

Job Summary

The Clinical Documentation Improvement (CDI) Specialist is responsible for reviewing clinical documentation to ensure accuracy, completeness, and compliance with regulatory and coding requirements. The role focuses on improving the quality of physician documentation to support accurate coding, reimbursement, severity of illness (SOI), and risk of mortality (ROM).

Key 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
• Ensure documentation supports accurate ICD‑10‑CM/PCS coding, DRG assignment, 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

Required Qualifications

• Registered Nurse (RN), or USRN with a strong clinical background
• 1+ years of experience in CDI with medical coding, or clinical documentation review
• Strong knowledge of ICD‑10‑CM/PCS, DRGs, CC/MCCs, and clinical indicators
• Familiarity with quality measures, SOI/ROM, and reimbursement methodologies
• Excellent written and verbal communication skills

ICD 10 CM/PCS coding Clinical Documentation CMS AHIMA ACDIS SOI/ROM Reimbursement Methodology DRG assignment CDI Specialist

Working Location

RDS Human Resource Management Consultancy