Medical Chart Reviewer

Zekai; United States; Remote; USD 39,000 - 58,000; Part time

Benefits offered by this job

Remote work

Contract role

Job summary

Zekai is seeking Medical Chart Reviewers (contract, remote) to apply clinical expertise to coding audits and AI data labeling. You will review charts, verify ICD-10-CM/PCS codes, and provide actionable feedback to improve model learning and data quality.

Ideal candidates hold CCS/CIC/CPC or RN with CDI experience, with MS-DRG knowledge and a proven chart review track record. Strong written/verbal communication and access to current code sets are required for success in this remote role.

Qualifications

• CCS/CIC/CPC or RN with chart review or CDI experience.
• Deep ICD-10-CM/PCS and MS-DRG knowledge.
• Experience reviewing charts in diverse settings (acute care, teaching hospitals, surgical, etc).
• Proficiency in reviewing diverse clinical documentation and identifying discrepancies.
• Strong written and verbal communication; meticulous attention to detail.
• Access to current ICD-10-CM/PCS code sets and MS-DRG tools.

Responsibilities

• Review and audit medical charts to verify accuracy and codes.
• Validate diagnosis and procedure coding, POA indicators, and MS-DRG assignments.
• Apply ICD-10-CM/PCS guidelines and MS-DRG criteria; flag gaps and queries.
• Collaborate with stakeholders to clarify requirements and ensure data integrity.
• Deliver feedback on charts, guidelines, and complex cases to improve workflows.
• Ensure accuracy and completeness of all review findings.

Skills

Medical coding knowledge

Chart review experience

Attention to detail

Communication skills

Education

AHIMA CCS

CIC

CPC

RN/clinical credential

Tools

MS-DRG grouper tools

Job description

Role Title: Medical Chart Reviewer

Role Type: Contractor

Location: US - Remote

our partner is engaging Medical Chart Reviewers (CCS / CIC / CPC certified, or RN / clinical background) to contribute their expertise to a dynamic project for a valued customer. In this role, you'll apply your expertise to help train next-generation AI systems. Your work will shape how models learn, reason, and perform through high-quality, real-world input. No prior experience in AI is required, your domain knowledge is what matters.

Scope of Work

• Review and audit medical charts, including admission notes, progress notes, operative reports, consults, lab and imaging results, and discharge summaries, to verify the accuracy and completeness of documentation and assigned codes.
• Validate diagnosis and procedure coding, sequencing, Present on Admission (POA) indicators, and MS-DRG assignment against the clinical documentation, identifying under-coding, over-coding, and missed CCs and MCCs.
• Apply clinical and coding standards, including the ICD-10-CM/PCS Official Guidelines for Coding and Reporting, AHA Coding Clinic guidance, and clinical validation criteria, while flagging documentation gaps and query opportunities.
• Collaborate with project stakeholders using both written and verbal communication to clarify requirements, resolve documentation ambiguities, and ensure data integrity.
• Deliver high-quality feedback on charts, coding guidelines, and complex cases to support project workflow improvements and enhance AI model understanding.
• Ensure accuracy and completeness of all review findings per current best practices and coding standards.

Preferred Qualifications

• Active AHIMA Certified Coding Specialist (CCS), AAPC Certified Inpatient Coder (CIC), AAPC Certified Professional Coder (CPC), or an RN / clinical credential with chart review or CDI experience.
• Thorough expertise in ICD-10-CM, ICD-10-PCS, and MS-DRG methodology, with hands-on experience in chart review, coding audit, or clinical documentation improvement (CDI).
• Experience reviewing charts in diverse settings, such as acute care, teaching hospitals, specialty units, surgical, trauma, oncology, cardiology, and transplant cases.
• Proficiency in reviewing various types of clinical documentation and identifying discrepancies or complex coding challenges.
• Strong written and verbal communication skills, demonstrating meticulous attention to detail and clarity.
• Access to current ICD-10-CM and ICD-10-PCS code sets, Official Coding Guidelines, and MS-DRG grouper tools.

This is a 100% remote contract role. Applicants must be located in: United States.