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Clinical Documentation Integrity Specialist - QA
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AledadeDetroit, MI, US- serp_jobs.job_card.full_time
CDI Specialist - QA
The CDI Specialist - QA will serve as a quality assurance leader by auditing the work of Clinical Documentation Integrity Specialists (CDIS) and Clinical Documentation Integrity Coders (CDI-Cs), ensuring complete, accurate, and compliant diagnostic documentation and coding in alignment with ICD-10-CM guidelines, CMS risk adjustment methodology, payer requirements, and Aledade's internal standards. This role plays a critical part in maintaining the integrity of documentation review workflows and improving the effectiveness of field-level education. The CDI-S QA will provide structured feedback to CDI staff, identify trends and training needs, support quality improvement initiatives, and collaborate with clinical, coding, and operational leaders. Occasional travel to practices may be required, with most work performed remotely. The ideal candidate is detail-oriented, quality-focused, and fluent inor willing to masterGoogle Suite tools.
Primary Duties :
- Conduct routine and focused audits of CDIS and CDI-C chart reviews to assess accuracy, compliance, completeness, and consistency. Identify documentation improvement opportunities and recommend corrections. Summarize audit findings and provide actionable feedback to CDI team members and leadership.
- Analyze trends across audit results to identify team- or market-level gaps. Collaborate with CDI leadership to design and refine quality standards, protocols, workflows, and internal guidance materials. Contribute to continuous quality improvement initiatives.
- Support and deliver internal training and calibration sessions for the CDI team. Assist in onboarding new team members by validating their documentation and coding reviews. Serve as a subject matter expert on CMS HCC risk adjustment and documentation integrity best practices.
Minimum Qualifications :
Preferred Key Skills and Abilities :