Targets RMS
Job Summary The Clinical Documentation Improvement (CDI) Specialist is responsible for reviewing clinical documentation to ensure accuracy, completeness, and compliance with regulatory and coding requirements. The role focuses on improving the quality of physician documentation to support accurate coding, reimbursement, severity of illness (SOI), and risk of mortality (ROM). Key Responsibilities Review inpatient and/or outpatient medical records to identify documentation gaps and opportunities for improvement Collaborate with physicians, coders, and clinical staff to clarify diagnoses, procedures, and clinical indicators Initiate and follow up on physician queries in accordance with compliant query guidelines Ensure documentation supports accurate ICD‑10‑CM/PCS coding, DRG assignment, SOI, ROM, and quality metrics Educate providers on documentation best practices and regulatory requirements Track and report CDI metrics such as query response rates, CC/MCC capture, and case mix index (CMI) Ensure compliance with CMS, AHIMA, ACDIS, and organizational policies Participate in audits, reviews, and performance improvement initiatives Required Qualifications Registered Nurse (RN), or USRN with a strong clinical background 1+ years of experience in CDI with medical coding, or clinical documentation review Candidate with DRG Validation experience is highly encouraged Strong knowledge of ICD‑10‑CM/PCS, DRGs, CC/MCCs, and clinical indicators Familiarity with quality measures, SOI/ROM, and reimbursement methodologies Excellent written and verbal communication skills Preferred Qualifications RN or USRN Experience with EHR systems (Epic, Cerner, Meditech, etc.) Experience in DRG Prior physician education or query management experience Experience working with US healthcare clients Skills & Competencies Strong analytical and clinical reasoning skills Attention to detail Ability to work independently and meet productivity targets Professional communication with physicians and stakeholders Knowledge of compliance and audit standards Pay: Php100,000.00 - Php130,000.00 per month Benefits Additional leave Health insurance On-site parking Opportunities for promotion Experience: PHRN/USRN: 1 year (Required) US Healthcare: 1 year (Required) Inpatient DRG Validation: 1 year (Preferred) Language: English (Required) License/Certification: CDI Certification (Preferred) Work Location: Remote
Targets RMS
