REMOTE - CDI Specialist

Job Description

Day-to-Day Responsibilities:

Review clinical documentation to ensure accuracy, completeness, and regulatory compliance. Work directly with physicians and clinical staff to clarify documentation. Perform Primary Diagnosis (PDX) shifting when appropriate to accurately reflect patient conditions and severity. Identify opportunities for documentation improvement and reimbursement optimization Collaborate with coding and revenue cycle teams. Support quality metrics and compliance initiatives.

Skills and Requirements

Active RN license required 2+ years of CDI experience within inpatient acute care in the last 5 years Must be able to demonstrate hands-on PDX shifting Understand when the primary diagnosis should be changed to a more appropriate diagnosis Must be able to identify CDI opportunities independently Strong ability to formulate appropriate physician queries Cannot depend solely on 3M to identify opportunities or formulate the query Candidates cannot be working another job simultaneously

Strong PDX shifting experience Ability to take and implement feedback Strong clinical background, with ICU, charge nurse, or bedside nursing experience being valuable Ability to identify documentation opportunities and independently formulate queries Ability to consistently meet required productivity metrics CCDS, CDIP, RHIA, RHIT, RN, or related certification Experience in large health systems or revenue cycle environments Advanced knowledge of DRG optimization, CC/MCC capture, and coding guidelines

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment without regard to race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to HR@insightglobal.com.