Senior CDI Reviewer: Documentation Integrity & Quality

University of Miami; United States; Remote; USD 90,000 - 130,000; Full time

Job summary

The University of Miami Health System seeks a CDI Second Level Reviewer to perform high-level, complex secondary case reviews ensuring documentation reflects disease severity, risk of mortality, and patient outcomes. You will collaborate with CDI, coding, and quality leadership to support regulatory compliance and performance metrics.

Required are an RN or MD with relevant CDI certifications, 3+ years inpatient CDI experience, and proficiency with ICD-10-CM/PCS, APR MS DRG, and CDI software.

Qualifications

• Education: Four (4) Year/bachelor’s degree required; BSN/BS/BA in related field required.
• Certification: Current RN or MD required; CCDS or CDIP certification required; Coding certification (CCS, CIC or CPC) preferred.
• Experience: 3+ years inpatient CDI; proficiency with ICD-10-CM/PCS, APR DRG and MS DRG; mortality/PSI/HAC quality reviews.
• Proficiency with CDI software, encoder, and Microsoft Office; strong written and verbal communication.

Responsibilities

• Ensures accuracy, completeness and quality of clinical information for outcomes measures.
• Performs high-level, complex secondary case reviews to identify documentation gaps.
• Ensures documentation reflects level of care, severity of illness, risk of mortality, and clinical validation.
• Applies knowledge of CMS star ratings, risk-adjustment systems to identify opportunities.
• Completes quality reviews focused on Mortality, HAC, and other quality metrics.
• Identifies trends and opportunities to improve querying, coding and documentation integrity.
• Communicates effectively with providers, HIM/coding, quality, CDI and other teams.
• Maintains documentation and participates in professional development activities.

Skills

RN license

MD license

CDS/CDIP certification

Coding certifications (CCS CIC CPC)

ICD-10-CM/PCS proficiency

APR MS-DRG knowledge

Microsoft Office

Education

Bachelor's degree

Graduate degree in Healthcare Admin/Informatics/Nursing

Tools

CDI software

Encoder (3M 360 Encompass)

Vizient/ Premier risk-adjustment knowledge

Job description

The University of Miami Health System seeks a CDI Second Level Reviewer to perform high-level, complex secondary case reviews ensuring documentation reflects disease severity, risk of mortality, and patient outcomes. You will collaborate with CDI, coding, and quality leadership to support regulatory compliance and performance metrics.

Required are an RN or MD with relevant CDI certifications, 3+ years inpatient CDI experience, and proficiency with ICD-10-CM/PCS, APR MS DRG, and CDI software.