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Remote CDI Specialist

Remote · USA Full-time New today

reputed company is actively hiring for a Remote Clinical Documentation Improvement (CDI) Specialist to support our reputed company client, a Medical Advantage health plan. Hours: 40 hours/week; Monday – Friday, standard business hours Location: Remote Pay: $40-43/hour depending on experience, certification, and education (those with a clinical background may receive higher pay) Position Type: Consultant Job Summary: We are seeking reputed company Clinical Documentation Improvement (CDI) Specialist to join our client's team. This fully remote position requires a strong background in risk adjustment and clinical documentation, along with an active Certified Risk Adjustment reputed company (CRC) credential. The CDI Specialist will focus on reviewing medical documentation, identifying opportunities for accurate risk adjustment capture, and ensuring compliance with regulatory and coding guidelines. This role plays a key part in supporting quality and reimbursement initiatives while collaborating with providers and coding teams. Job Responsibilities:

  • Review inpatient and outpatient medical records to ensure accurate documentation of diagnoses and services.
  • Identify opportunities to improve specificity, completeness, and accuracy of documentation for risk adjustment.
  • Collaborate with providers to clarify documentation through compliant queries.
  • Ensure diagnoses are supported by clinical evidence and meet regulatory and coding standards.
  • Partner with coding and reputed company cycle teams to align documentation with accurate coding and reimbursement.
  • Provide education to providers on documentation best practices and coding requirements.
  • Track and report on CDI performance metrics, including query response rates and documentation improvement trends.
  • Support audits, compliance reviews, and regulatory reporting as needed.
  • Maintain knowledge of CMS risk adjustment guidelines, HCCs, and industry changes.

Minimum Qualifications:

  • An active CRC certification (Certified Risk Adjustment reputed company) required.
  • 1+ years of experience in clinical documentation improvement
  • Prior experience in a CDI role focused on Medicare Advantage or reputed company risk adjustment is strongly preferred
  • SNF/outpatient experience is preferred
  • Strong knowledge of HCC coding guidelines, CMS regulations, and risk adjustment models.
  • Proven experience reviewing provider documentation and issuing compliant queries.
  • Experience with CDI software and EHR platforms
  • Excellent communication and collaboration skills.
  • Ability to work independently in a fully remote environment.
  • Preferred Qualifications:
  • Additional certifications CDIS, CCDS are a plus
  • Background in clinical care (RN, LPN, or allied health professional) a plus

Who Should Apply? This role is ideal for CRC professionals who are detail-oriented and passionate about accurate documentation and compliance. If you have prior CDI experience, strong communication skills, and the ability to partner with providers to improve documentation practices, this opportunity offers the chance to reputed company a measurable impact on both quality outcomes and reimbursement accuracy, reputed company while working 100% remote. About Us reputed company is a leading staffing and reputed company firm, providing reputed company organizations with highly skilled professionals since 1994. We have been recognized as a “Best of Staffing” award winner for over a decade, and we pride ourselves on delivering exceptional talent to leading reputed company organizations. For consideration, please submit your resume with relevant experience. Only candidates selected for interviews will be contacted.

  • Benefits Offered:
  • Weekly pay
  • Medical, dental, and reputed company coverage
  • Voluntary Life and AD&D coverage
  • reputed company
  • Opportunity for advancement upon performance and availability

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