Physician Advisor (CDI Programs) | Remote

Type: Hourly contract – 10-40 hrs/week – Remote

Responsibilities

• Lead clinical documentation integrity programs for inpatient and/or outpatient settings, overseeing concurrent and retrospective review workflows.
• Evaluate AI-generated clinical documentation improvement suggestions, physician queries, and coding recommendations for clinical accuracy and compliance.
• Conduct and review clinical documentation to ensure accurate capture of diagnoses, procedures, severity of illness, and risk of mortality.
• Develop and manage physician query processes in alignment with AHIMA and ACDIS guidelines.
• Monitor CDI program KPIs including query response rates, CC/MCC capture rates, case mix index, and DRG accuracy.
• Collaborate with coding, compliance, and clinical teams to address documentation gaps and improve query processes.
• Provide education to physicians and clinical staff on documentation requirements and best practices.
• Ensure compliance with Official Coding Guidelines, CMS regulations, and payer-specific requirements.
• Annotate AI outputs and provide structured clinical feedback to support AI training datasets.

Requirements

• Strong relevant experience in clinical documentation integrity or improvement, with leadership experience.
• Deep knowledge of MS-DRG methodology, CC/MCC hierarchies, and ICD-10-CM/PCS coding guidelines.
• Expertise in physician query management per AHIMA and ACDIS compliant query standards.
• Strong clinical background with the ability to interpret medical records and clinical documentation.
• Proficiency with CDI software platforms (3M, Nuance, Optum360, or equivalent) and EHR systems.
• Exceptional written and verbal English communication skills.
• High attention to detail with the ability to critically evaluate clinical documentation and AI-generated outputs.
• Comfortable working independently in a fully remote environment.

Pay

$84 per hour