CDI Auditor

Greetings from Healthrecon Connect !!

Clinical Documentation Integrity (CDI) Auditing Perform comprehensive CDI audits for physician, ambulatory, and outpatient documentation.

Review provides notes for completeness, clarity, specificity, medical necessity, and compliance with regulatory standards.Identify documentation gaps, missed diagnoses, unspecified conditions, and conflicting or ambiguous documentation.

Validate that clinical documentation supports reported diagnoses and procedures.

Track and report audit findings, provider education outcomes, and documentation trends.

Role & responsibilities

• Prepare clear, concise provider-specific audit summaries.
• Deliver constructive feedback that enhances documentation accuracy and coding compliance.
• Assist in developing education plans tailored to specific providers, specialties, or recurring documentation issues.
• Support recurring provider education sessions (virtual or recorded) to address trends.
• Contribute to process improvements that increase clean claim rate and reduce denials.
• Validate EM levels, procedure coding, modifiers, and medical necessity coverage guidelines.
• Audit encounter-level coding to ensure correct code selection and support clean claim submission.
• Assign accurate and compliant ICD-10-CM, CPT, and HCPCS codes based on provider documentation.
• Proven ability to review and evaluate physician documentation for completeness and specificity.
• Excellent written communication skills for provider feedback reports
• Ensure adherence to CMS guidelines, NCCI edits, payer policies, and audit methodologies.
• Maintain >96% coding accuracy and >98% audit accuracy.
• Support internal compliance initiatives and contribute to ongoing CDI improvement projects.
• Certification: CCDS. CDEO, CDIP, CPHQ, CCS OR CPC (last to be looked for) certification

Preferred candidate profile

• Minimum 5 years of medical coding experience (physician/ambulatory preferred).
• Minimum 2-3 years of CDI audit experience or mixed coding Audit and CDI (minimum 1.5-2 years in CDI exclusively).
• Strong knowledge of ICD-10-CM, CPT, HCPCS, EM guidelines, and payer policies.
• Proven ability to review and evaluate physician documentation for completeness and specificity
• Experience with specialties such as Internal Medicine, Family Medicine, Orthopaedics, Cardiology, Surgery, or Rehab.
• Exposure to EMR/EHR systems (Athena, Epic, Cerner, eClinicalWorks, etc.).
• Strong analytical and clinical interpretation skills
• High attention to detail and accuracy
• Ability to provide constructive, provider-friendly feedback
• Clinical terminology and anatomy knowledge
• Understanding of payer guidelines and DRG/EM levelling concepts (where applicable)
• Ability to work in a fast-paced environment with shifting priorities.

Remote

Shift : Straddle (12.00p.m to 9.00.p.m)

US calendar applicable

Interested candidates kindly share your updated resume to [email protected]