CDI Reconciliation Auditor

Healthcare Financial Resources Inc.; United States; Remote; USD 70,000 - 90,000; Full time

Job summary

Healthcare Financial Resources Inc. is seeking a CDI Reconciliation Auditor to perform detailed quality reviews and reconciliations of clinical documentation and coding outcomes. This role ensures compliance with regulatory standards and educates teams on best practices, contributing to improved financial health outcomes for clients.

Qualifications

• Bachelor’s degree in Nursing, Health Information Management, or a related field required.
• 3-5 years of experience in CDI, coding, or clinical auditing roles needed.
• Certified Clinical Documentation Specialist or Coding Specialist preferred.

Responsibilities

• Conduct reconciliations of CDI and coding outcomes.
• Perform quality audits on Physician Audit reviews.
• Collaborate with teams to improve processes based on audit findings.

Skills

Analytical skills

Problem-solving

Attention to detail

Communication

Education

Bachelor’s degree in Nursing or Health Information Management

Tools

Coding software

EHR systems

Job description

CDI Reconciliation Auditor page is loaded

CDI Reconciliation Auditor

Apply locations US - Remote time type Full time posted on Posted 4 Days Ago job requisition id JR102544

About Us:

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.

We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.

JOB SUMMARY:

The CDI Reconciliation Auditor is responsible for performing detailed quality reviews and reconciliations of clinical documentation and coding outcomes, with a focus on DRG (Diagnosis-Related Group) validation and Physician Audit reviews. This role ensures that documentation supports accurate coding and billing practices, in compliance with regulatory and payer requirements.

ESSENTIAL DUTIES AND RESPONSIBILITIES:
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

• Conduct reconciliations of CDI and coding outcomes to ensure alignment with final DRG assignments.
• Review discrepancies between CDI specialists and coders, resolving variances to support accurate claim submission.
• Perform quality audits on Physician Audit reviews to validate the appropriateness of coding and documentation.
• Ensure clinical documentation meets regulatory standards, payer guidelines, and organizational policies.
• Identify trends and patterns in documentation and coding errors, providing feedback and education to CDI and coding teams.
• Collaborate with internal teams to develop and implement process improvements based on audit findings.
• Provide education and training to CDI and coding staff on reconciliation outcomes and audit findings.
• Serve as a liaison between CDI specialists, coders, and physicians to resolve documentation and coding queries.
• Maintain up-to-date knowledge of coding guidelines (ICD-10, CPT, etc.), payer policies, and regulatory requirements.
• Prepare and present regular reports on reconciliation and audit outcomes, including key metrics and recommendations.

• Bachelor’s degree in Nursing, Health Information Management, or a related field; or equivalent clinical experience.
• 3-5 years of experience in CDI, coding, or clinical auditing roles.
• Strong background in DRG validation and Physician Audit processes.
• Experience with healthcare coding systems and standards (ICD-10, CPT, HCPCS).
• Certified Clinical Documentation Specialist (CCDS) or Clinical Documentation Improvement Practitioner (CDIP) preferred.
• Certified Coding Specialist (CCS) or equivalent coding certification required.
• Strong analytical and problem-solving skills.
• Proficient in coding software and EHR systems.
• Excellent written and verbal communication abilities.
• Detail-oriented with a focus on accuracy and compliance.

PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

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CorroHealth sits at the center of the revenue cycle revolution. Fundamental operations of the revenue cycle are supported through our expert teams while we recast the role of clinicians through automation. This shift to a true clinical revenue cycle helps us achieve our core purpose – exceed client financial health goals.

For each patient population, CorroHealth automates key clinical aspects of the cycle. Our platforms focus on capture and application of clinical documentation while easing the burden on physicians.

Scalability is prioritized in the support of client program operations. As with most revenue cycle partners, our skilled and enthusiastic team is available to outsource any portion of the cycle. However, we can also complement client programs with additional expert support or upskill existing client teams to meet program demands.

Whether our team is deployed directly, or automation is incorporated for a more programmatic solution, CorroHealth delivers.

Applicants will only receive job-related emails from the domain @corrohealth.com.

Additionally, it is important to emphasize that CorroHealth will never ask for money in return for a job offer.