Second Level Reviewer CDI
Houston Metro Area, Texas
Category: Healthcare
Reference ID: 10078538
Shortcut: http://addisongroup.gosnaphop.com/Pjdt9k
Job Title: Second Level Reviewer CDI
Location (city, state): Remote – Candidates must reside in TX, OK, TN, LA, AR, FL, or GA
Industry: Healthcare / Clinical Documentation Integrity (CDI)
Pay: $45 - $56.50 / hour
About Our Client:
Our client is a large healthcare system focused on delivering high-quality, efficient patient care. This role will support the development of a dedicated CDI Denials & Appeals team.
Job Description:
Seeking an experienced Second Level Reviewer CDI Specialist to perform retrospective reviews focused on DRG validation, clinical validation, denials, appeals, and compliant physician queries.
Key Responsibilities:
- Perform retrospective CDI reviews and DRG validations
- Review denials/appeals and identify clinical validation opportunities
- Review mortality cases with focus on SOI/ROM and expected mortality
- Create and follow up on compliant physician queries
- Ensure documentation supports accurate coding and compliance
- Meet productivity expectations of approximately 8–10 DRG validations per day
- Collaborate with CDI leadership and support project reporting
Qualifications:
- 3–5+ years of CDI experience
- Active CDI certification
- BSN with active Compact RN license
- Strong clinical validation, denials, and appeals experience
- Experience with mortality reviews, SOI/ROM, and expected mortality
- Strong knowledge of AHIMA/ACDIS compliant query practices
- Experience in a 500+ bed, Level 1 Trauma/Teaching Hospital
- ICU/bedside clinical experience
- Epic and 3M 360 CAC experience preferred
- Ability to work independently and quickly adapt to new workflows
Additional Details:
- 6 openings
- Remote
- Monday–Friday; standard hours 8 AM–5 PM CST
- Flexible start between 6–9 AM CST
- Approximately 1 week of project-specific training
Perks:
- Fully remote
- Flexible daily start time
- Opportunity to help build out a new CDI Denials & Appeals team
- High-level CDI project experience within a large healthcare system
| Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request. |
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