CDI Second Level Reviewer
$145,000–$145,000 year
RemoteUnited States
Job Summary
Perform secondary reviews of high-impact cases, including length-of-stay variances, unexpected mortalities, and quality metrics like PSIs or HACs. Identify missed documentation opportunities affecting severity, risk adjustment, and reimbursement, then send queries to clarify gaps. Deliver feedback and education to concurrent CDI staff while analyzing trends to support quality and performance improvement initiatives. Partner with leadership to refine review criteria and ensure alignment with coding guidelines. This role serves as an escalation layer beyond concurrent review, requiring a credentialed Clinical Documentation Specialist with five years of experience. Candidates must be licensed in NYS as an RN, NP, or PA and possess strong DRG methodology knowledge.
Required Qualifications
- Licensed in NYS, RN, NP or PA who is a credentialed Clinical Documentation Specialist CCDS, or CDIP
- minimum of 5 years recent CDI experience
- Demonstrated advanced CDI knowledge and strong clinical foundation
- Proven experience in concurrent CDI review
- Strong understanding of DRG methodology, quality metrics, and documentation impact
- Excellent critical thinking and communication skills
Desired Qualifications
- Preferred Epic EMR and 3M 360 application proficiency
- High level of clinical and coding expertise
- Ability to identify nuanced documentation gaps in complex cases
- Detail-oriented with strong problem-solving skills
- Collaborative mindset with ability to educate and influence peers
- Comfortable working independently in a specialized review workflow
- Strong sense of accountability and ownership for high-impact work
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