Remote Clinical Documentation Improvement Specialist

UASI; United States; Remote; USD 85,000 - 120,000; Full time

Benefits offered by this job

Full benefits package

PTO and top pay

Remote work across the U.S.

Job summary

UASI is seeking a Clinical Documentation Improvement Specialist for a fully remote role in the United States. The candidate will review medical records, collaborate with clinicians and coders, and drive documentation quality to improve coding accuracy and reimbursement.

The ideal applicant has inpatient CDI experience, bedside nursing in acute care, and RN licensure. Familiarity with 3M and Epic software is preferred, with CCDS/CDIP encouraged but not mandatory.

Qualifications

• Minimum 2 years inpatient CDI experience
• Minimum 2 years bedside nursing in acute care (ICU/Med/Surg/ED)
• Knowledge of ICD-10-CM, MS-DRGs, coding guidelines, and compliance standards
• Certification: RN required; CCDS/CDIP preferred but not required
• Familiarity with MS Office, email, VPNs, and video conferencing tools

Responsibilities

• Review and evaluate medical record documentation for completeness, accuracy, and compliance
• Collaborate with physicians, nurses, and coding professionals to ensure appropriate clinical documentation
• Identify opportunities for documentation improvement to support coding accuracy, reimbursement, and clinical outcomes
• Analyze medical records to ensure documentation supports quality care and appropriate reimbursement
• Formulate compliant, clinically sound physician queries

Skills

CDI experience

RN bedside nursing

ICD-10-CM knowledge

MS-DRGs knowledge

3M/Epic software

communication

MS Office

Education

Registered Nurse license (RN)

Tools

3M

Epic

Job description

UASI is seeking a Clinical Documentation Improvement Specialist for a fully remote role in the United States. The candidate will review medical records, collaborate with clinicians and coders, and drive documentation quality to improve coding accuracy and reimbursement.

The ideal applicant has inpatient CDI experience, bedside nursing in acute care, and RN licensure. Familiarity with 3M and Epic software is preferred, with CCDS/CDIP encouraged but not mandatory.