[Hiring] Clinical Documentation Integrity Review Consultant @24-MAG

Role Description

We are sharing a specialised part-time consulting opportunity for United States-based healthcare professionals experienced in clinical documentation integrity, documentation improvement, DRG accuracy, HCC risk adjustment, physician query management, coding integrity, clinical record review, and healthcare compliance workflows. This role supports current and upcoming remote consulting opportunities focused on AI-assisted clinical documentation evaluation, physician query review, coding recommendation assessment, and high-quality project execution. Selected professionals will apply clinical documentation integrity expertise to evaluate AI-generated documentation improvement suggestions, review clinical and coding logic, identify documentation gaps, and provide structured feedback based on detailed project criteria.

Key Responsibilities

• Clinical Documentation Review
  • Review inpatient and/or outpatient clinical documentation workflows for accuracy, completeness, compliance, and coding relevance.
  • Evaluate AI-generated documentation improvement suggestions, physician queries, and coding recommendations for clinical accuracy and practical usefulness.
  • Assess documentation for accurate capture of diagnoses, procedures, severity of illness, risk of mortality, and care complexity.
  • Identify documentation gaps, unclear clinical support, incomplete query logic, and missed opportunities for compliant documentation improvement.
• Physician Query & Coding Integrity Evaluation
  • Review physician query processes for alignment with AHIMA, ACDIS, and compliant query standards.
  • Evaluate outputs involving MS-DRG methodology, CC/MCC capture, ICD-10-CM/PCS coding guidance, DRG accuracy, and HCC risk adjustment.
  • Assess whether documentation recommendations appropriately support coding integrity, clinical validity, and compliance requirements.
  • Support review of CDI-related KPIs such as query response rates, CC/MCC capture rates, case mix index, DRG accuracy, and documentation quality indicators.
• Structured Clinical Feedback & Quality Control
  • Annotate AI-generated clinical documentation and coding outputs and provide structured feedback to support quality improvement.
  • Explain review decisions clearly, consistently, and with strong clinical documentation integrity judgment.
  • Evaluate outputs for alignment with Official Coding Guidelines, CMS regulations, payer-specific requirements, and internal documentation standards.
  • Follow detailed task instructions, quality criteria, and project-specific review guidelines accurately.

Qualifications

• 5+ years of experience in clinical documentation integrity, clinical documentation improvement, CDI operations, coding quality, or related healthcare documentation workflows.
• At least 2 years of experience in a CDI manager, CDI leader, team lead, supervisor, or program oversight role.
• Deep knowledge of MS-DRG methodology, CC/MCC hierarchies, ICD-10-CM/PCS coding guidelines, and documentation requirements.
• Expertise in physician query management using AHIMA and ACDIS compliant query standards.
• Strong clinical background with the ability to interpret medical records, clinical documentation, and coding-related recommendations.
• Proficiency with CDI platforms such as 3M, Nuance, Optum360, or similar systems, as well as EHR workflows.
• Exceptional written and verbal English communication skills.
• High attention to detail and ability to critically evaluate clinical documentation and AI-generated outputs.
• Ability to work independently in a remote, project-based environment.

Educational Background

• Professional background in clinical documentation integrity, clinical documentation improvement, nursing, health information management, medical coding, coding compliance, or healthcare quality is highly relevant.
• RN, RHIA, CCS, CDIP, CCDS, or similar clinical, coding, or health information background may be especially valuable depending on project scope.
• Experience in hospitals, health systems, physician groups, inpatient CDI, outpatient CDI, coding departments, compliance teams, or revenue cycle operations may support project fit.
• Practical experience with physician query workflows, DRG review, HCC documentation, EHR systems, coding platforms, and CDI software may be especially relevant.

Nice to Have

• CCDS, CDIP, RN, RHIA, CCS, or similar clinical documentation, coding, or health information credential.
• Experience with HCC risk adjustment, outpatient CDI programs, or value-based care documentation workflows.
• Familiarity with AI-assisted CDI tools, computer-assisted coding, NLP-based documentation tools, or clinical documentation automation.
• Experience presenting CDI performance metrics, query trends, DRG accuracy findings, or documentation improvement opportunities to clinical or executive leadership.
• Strong ability to identify clinical validity concerns, documentation gaps, coding integrity risks, and compliant query opportunities.

Why This Opportunity

• Apply clinical documentation integrity expertise to structured remote healthcare project work.
• Contribute to high-quality AI-assisted documentation review and coding integrity evaluation.
• Use CDI leadership, physician query experience, DRG knowledge, and clinical record review skills in a focused evaluation environment.
• Work on flexible assignments aligned with clinical documentation, coding compliance, CDI operations, and revenue cycle expertise.
• Remote structure with competitive hourly compensation.

Contract Details

• Independent contractor role.
• Fully remote with flexible scheduling.
• United States-based professionals are required for this opportunity.
• Part-time project-based commitment depending on availability, onboarding status, and project needs.
• Competitive rates of up to $65 per hour depending on CDI experience, clinical documentation expertise, leadership background, and project scope.
• 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.