[Hiring] Clinical Documentation Integrity Leader @Mercor

Role Description

Lead clinical documentation integrity programs for inpatient and outpatient settings. Oversee concurrent and retrospective review workflows.

• Evaluate AI-generated clinical documentation improvement suggestions for accuracy and compliance.
• Ensure alignment with clinical standards.
• Conduct and review clinical documentation to capture diagnoses, procedures, severity of illness, and risk of mortality accurately.
• Develop and manage physician query processes following 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 on best practices.

Qualifications

• 5+ years of experience in clinical documentation integrity or improvement, with 2+ years in a manager or leadership role.
• 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.

Requirements

• CCDS (Certified Clinical Documentation Specialist) or CDIP (Clinical Documentation Improvement Practitioner) credential preferred.
• Experience with HCC risk adjustment and outpatient CDI programs.
• Background in RN, RHIA, CCS, or similar clinical or coding credential.
• Familiarity with AI-assisted CDI tools (e.g., Nuance DAX, 3M M Modal) and comfort evaluating AI-generated clinical content.
• Experience presenting CDI performance metrics to clinical and executive leadership.

Benefits

• Compensation: $84/hour
• Type: Contract
• Location: Remote

Application Process

• Upload resume
• AI interview based on your resume
• Submit form

Resources & Support

• For details about the interview process and platform information, please check: Interview Process
• For any help or support, reach out to: [email protected]