CDI Specialist
Job at a glance
CDI Specialist | $50–$150/hr | Worldwide Remote Join Mercor as a Clinical Documentation Integrity (CDI) Specialist and apply your inpatient coding and documentation expertise to evaluate AI-driven CDI workflows. This flexible, remote contractor role is ideal for experienced CDI professionals, inpatient coders, or HIM specialists looking to contribute to cutting-edge healthcare AI development. What You'll Do Review AI-agent attempts at realistic CDI and coding tasks, judging whether each disposition is correct and adequately supported by the clinical record.
Confirm that work is actually completed and recorded — codes changed, queries sent, holds placed, DRGs recomputed, and CDI reviews filed — not merely described. Identify fabricated or overstated work, including cited labs, documents, or prior encounters that don't exist in the record, or DRG figures not produced by the grouper. Assess completeness and determine whether the correct action was applied: code fix, query, clinical-validation query, or leave-alone.
Write clear, specific agree/disagree rationales for each AI attempt reviewed. Clinical Documentation Knowledge Required Coding & Pre-Bill Cycle: ICD-10-CM/PCS assignment, POA reporting, DRG assignment and reimbursement cycle, concurrent and retrospective review, DRG reconciliation, and coded-diagnosis tie-out to source documentation. Judgment & Evaluation: CC/MCC impact and DRG movement; principal-diagnosis sequencing; dollar and quality impact of code changes.
Clinical Standards & Criteria: Applying KDIGO AKI staging, sepsis, respiratory failure, malnutrition, and CKD staging criteria; UHDDS reporting rules; clinical validation of diagnoses. Query & Compliance Discipline: AHIMA/ACDIS-compliant, non-leading query construction; understanding when a query is required versus when specificity is already documented. Documentation & Evidence: Query vs.
CDI-review vs. note standards; hold/pending mechanics; evidence provenance — only citing data actually present in the record. Tools: CAC/CDI platforms (e.g., Dolbey Fusion, 3M 360 Encompass, Nuance/Optum360), DRG groupers, and EHR systems such as Epic. Requirements 2+ years of professional experience in inpatient hospital CDI (specialist or leadership), inpatient DRG coding/auditing, or clinical-documentation denial management.
Current or recent hands-on work under ICD-10-CM/PCS and MS-DRGs. Ability to identify unsupported diagnoses, leading queries, missed CC/MCCs, or rubber-stamped accounts on sight. Credentials such as CCDS, CDIP, CCS, RHIA/RHIT, or RN with CDI experience (or equivalent) preferred. Comfort reading full clinical records — H&Ps, consults, progress notes, discharge summaries, labs, and flowsheets — within CAC/CDI software environments.