Job Details

About the job Remote | CDI Specialist - $45-$115/hour

We are sharing a specialised part-time consulting opportunity for experienced Clinical Documentation Integrity professionals with hands-on expertise in inpatient CDI, DRG coding and auditing, or clinical-documentation denial management.

This role supports an advanced AI initiative focused on evaluating realistic inpatient CDI and coding workflows. Selected professionals will review AI-generated work against the clinical record, assess coding and documentation accuracy, identify unsupported diagnoses or incomplete actions, and determine whether appropriate CDI, query, coding, and DRG processes have been followed.

Key Responsibilities

CDI & Inpatient Coding Review

• Review realistic inpatient CDI and coding tasks involving ICD-10-CM/PCS and MS-DRG workflows
• Evaluate concurrent and retrospective pre-bill reviews
• Assess working versus final DRG reconciliation
• Confirm coded diagnoses are appropriately supported by source documentation
• Review POA reporting, principal-diagnosis sequencing, and related coding decisions

Clinical Validation & DRG Evaluation

• Evaluate CC/MCC impact, DRG movement, severity of illness, and risk-of-mortality implications
• Assess whether diagnoses are clinically supported by the complete patient record
• Apply relevant clinical criteria involving conditions such as AKI, sepsis, respiratory failure, malnutrition, and CKD
• Identify unsupported, templated, or copy-forward diagnoses requiring further review
• Evaluate downstream effects of coding changes on DRG assignment and related outcomes

Query & Compliance Review

• Assess provider queries for compliance with AHIMA and ACDIS principles
• Identify leading or otherwise inappropriate query construction
• Determine when clarification requires a provider query and when existing documentation already provides sufficient specificity
• Apply the principle that clinical indicators support a query rather than independent alteration of provider-documented diagnoses
• Distinguish appropriate code corrections, clinical-validation queries, clarification queries, and leave-as-is dispositions

Workflow Completion & Evidence Verification

• Confirm that required actions were fully completed and documented
• Verify that queries were sent, holds were placed, codes were updated, and DRGs were recomputed where appropriate
• Review CDI notes, clinical documentation reviews, and supporting documentation for completeness
• Identify unsupported claims involving laboratory results, previous encounters, provider responses, or grouper-generated DRG and reimbursement figures
• Write clear agree/disagree rationales explaining the accuracy and completeness of each reviewed attempt

Ideal Profile

Strong candidates may have:

• At least 2 years of professional experience in inpatient hospital CDI, inpatient DRG coding or auditing, or clinical-documentation denial management
• Current or recent hands-on experience with ICD-10-CM/PCS and MS-DRGs
• Strong knowledge of inpatient coding, DRG assignment, clinical validation, and documentation workflows
• Ability to identify unsupported diagnoses, missed CC/MCC opportunities, inappropriate queries, and incomplete CDI processes
• Experience reading comprehensive clinical records including H&Ps, consults, progress notes, discharge summaries, laboratory results, and flowsheets
• Strong professional judgment, attention to detail, and written communication skills

Educational Background

• CCDS, CDIP, CCS, RHIA, RHIT, or comparable professional credentials are highly relevant
• Registered nurses with substantial CDI experience may also be strong candidates
• Hospital coding, HIM, nursing, or related clinical documentation backgrounds are particularly relevant
• Equivalent professional experience involving intensive inpatient documentation and coding review may also be considered

Nice to Have

• Experience with Dolbey Fusion, 3M 360 Encompass, Nuance, Optum360, or comparable CAC/CDI platforms
• Familiarity with professional DRG groupers
• Experience using Epic or comparable EHR systems
• Strong knowledge of UHDDS reporting requirements
• Experience with CDI-related denials or clinical-validation appeals
• Familiarity with KDIGO criteria and other commonly applied clinical standards
• Experience reviewing complex principal-diagnosis and sequencing scenarios
• Prior data annotation, structured review, or AI evaluation experience

Why This Opportunity

• Apply specialised CDI and inpatient coding expertise to advanced AI evaluation
• Work with realistic hospital documentation, coding, DRG, and query workflows
• Use professional judgment to identify subtle documentation and clinical-validation errors
• Help improve the accuracy and reliability of AI systems operating in complex healthcare workflows
• Participate in flexible remote consulting work with competitive hourly compensation

Contract Details

• Independent contractor role
• Fully remote with flexible scheduling
• Competitive rates between $45-$115 per hour depending on expertise and project scope
• Work may include CDI review, inpatient coding evaluation, DRG analysis, clinical validation, query assessment, and structured quality feedback
• Weekly payments via Stripe or Wise
• Projects may be extended, shortened, or adjusted depending on scope and performance
• Work will not involve access to confidential or proprietary information from any employer, client, or institution

About the Platform

This opportunity is available through 24-MAG LLC. We connect experienced professionals with remote consulting opportunities across technical, evaluation, and project-based workstreams.

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