Diagnosis Validation Reviewer

CSI Companies; United States; Remote; USD 90,000 - 130,000; Full time

Job summary

CSI Companies is seeking a clinically knowledgeable physician to perform medical record reviews and provide diagnostic documentation support in a remote environment. The role emphasizes accuracy, clarity, and efficient productivity while adhering to established workflows.

The ideal candidate has a physician background (foreign-trained or U.S.-trained) with strong clinical knowledge, excellent communication skills, and experience in risk adjustment and HCC methodologies.

Qualifications

• Physician background (foreign-trained or U.S.-trained accepted).
• Strong clinical knowledge.
• Excellent written and verbal communication skills.
• Experience with Risk Adjustment.
• Experience with HCC methodologies.
• Knowledge of medical terminology.
• Experience reviewing clinical documentation.

Responsibilities

• Evaluate complex medical records for documentation support of diagnoses.
• Translate medical record findings into clear, concise clinical comments.
• Balance quality, accuracy, and productivity in a structured remote review environment.
• Utilize training materials, clinical resources, and independent research to assess unfamiliar conditions.

Skills

Clinical knowledge

Medical terminology

Written communication

Verbal communication

Detail-oriented

Remote work adaptability

Education

MD/DO degree

Job description

The ideal candidate is a clinically knowledgeable, detail-oriented non-practicing physician with strong clinical judgment, chart review experience, and the ability to evaluate complex medical records for documentation support of diagnoses. They can translate medical record findings into clear, concise clinical comments and are comfortable balancing quality, accuracy, and productivity in a structured remote review environment. Candidates with experience in clinical documentation review, coding, CDI, risk adjustment, HCCs, outpatient review, or diagnosis validation are especially well suited for this role. The strongest candidates will be self-directed, adaptable, quick to learn new workflows, and comfortable using training materials, clinical resources, and independent research to accurately assess unfamiliar conditions.

Requirements

• Physician background (foreign-trained or U.S.-trained accepted)
• Strong clinical knowledge
• Excellent written and verbal communication skills
• Experience with Risk Adjustment
• Experience with HCC methodologies
• Knowledge of medical terminology
• Experience reviewing clinical documentation