Remote Clinical Documentation Integrity Specialist

Guidehouse Inc.; United States; Remote; USD 68,000 - 113,000; Full time

Job summary

Guidehouse is seeking a Clinical Documentation Integrity Specialist to review health records and collaborate with providers and coding teams to improve documentation quality and reimbursement accuracy. This role focuses on identifying opportunities to clarify diagnoses and procedures and generating compliant queries per industry guidelines.

The candidate will work with CDI software and EHR systems, ensuring adherence to official coding guidelines and DRG principles while maintaining productivity

Qualifications

• Bachelor's degree required or equivalent experience.
• RN, MD or MD Equivalent, RHIA, RHIT, CCS with license preferred.
• 2+ years acute care inpatient hospital coding or CDI experience.
• Familiarity with encoder and DRG assignment.
• Maintain knowledge of official coding guidelines and coding clinics.

Responsibilities

• Reviews medical records to identify CDI opportunities.
• Collaborates with providers and coding team to ensure accurate documentation for appropriate reimbursement and clinical detail.
• Prepares compliant physician queries following ACDIS/AHIMA guidelines.
• Identifies principal and secondary diagnoses and significant procedures to assign working MS-DRG.
• Updates DRG based on documentation during reviews to reflect expected LOS and SOI/ROM.

Skills

CDI experience

DRG assignment

Encoder familiarity

Medical terminology

Education

Bachelor's degree

Tools

CDI software

EHR systems

Encoders

Job description

Guidehouse is seeking a Clinical Documentation Integrity Specialist to review health records and collaborate with providers and coding teams to improve documentation quality and reimbursement accuracy. This role focuses on identifying opportunities to clarify diagnoses and procedures and generating compliant queries per industry guidelines.

The candidate will work with CDI software and EHR systems, ensuring adherence to official coding guidelines and DRG principles while maintaining productivity