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Clinical Documentation Integrity Specialist - QA

Clinical Documentation Integrity Specialist - QA

AledadeDetroit, MI, US
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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), en...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Lead QA Engineer

Lead QA Engineer

RIVET WorkDetroit, Michigan, United States
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Hybrid Flexibility | Software Startup | Among Coolest Midwest Tech Offices .RIVET is how construction labor gets to work. RIVET's software platform transforms the way contractors...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
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Senior QA- Integration Test Engineer

Senior QA- Integration Test Engineer

GuidehouseDetroit, MI, US
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Software Development & Support (Digital).Design, develop, and execute integration test plans, test cases, and test scripts. Collaborate with developers, business analysts, and other QA team memb...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
Lead QA Engineer

Lead QA Engineer

Rivet-workDetroit, Michigan, United States
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Hybrid Flexibility | Software Startup | Among Coolest Midwest Tech Offices.RIVET is how construction labor gets to work.RIVET’s software platform transforms the way contractors manage, plan, schedu...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Lead Software Development Engineer - (QA)

Lead Software Development Engineer - (QA)

BarcoDetroit, MI, US
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Barco designs technology to enable bright outcomes around the world.Seeing beyond the image, we develop visualization and collaboration solutions to help you work together, share insights, and wow ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Manufacturing QA Engineer

Manufacturing QA Engineer

Gatik AiDetroit, Michigan, United States
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Gatik, the leader in autonomous middle-mile logistics, is revolutionizing the B2B supply chain with its autonomous transportation-as-a-service (ATaaS) solution and prioritizing safe, consistent del...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Customer Service Supervisor (Training & QA)

Customer Service Supervisor (Training & QA)

Central City HealthDetroit, Michigan, United States
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Central City Health (CCH) has been serving the under-housed and at-risk population in metro Detroit since 1972, by providing integrated healthcare services. Our services include primary and pediatri...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Manager, International R&D / QA, Cheese Category

Manager, International R&D / QA, Cheese Category

Little CaesarsDetroit, MI
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Lead and manage the development of ingredients, focusing on the cheese category, to enable company’s strategy and growth plans for international markets. This includes supplier development around th...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Clinical Documentation Integrity Specialist - QA

Clinical Documentation Integrity Specialist - QA

AledadeDetroit, MI, US
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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 :

  • Bachelor's degree in a healthcare-related field or equivalent experience required
  • Current certification as a Certified Professional Coder (CPC), or equivalent
  • CDEO (AAPC), CRC (AAPC), or CCDS-O (ACDIS) certification required
  • Minimum of 3 years recent experience in Clinical Documentation Integrity or 5+ years of risk adjustment auditing experience
  • Deep understanding of ICD-10-CM coding, HCC risk adjustment, documentation compliance, and value-based care principles
  • Strong written and verbal communication skills, with experience delivering feedback to peers or staff.
  • Demonstrated ability to identify documentation gaps and explain the clinical and financial impacts of inaccurate coding
  • Experience with EHR systems, chart abstraction, and outpatient clinical workflows
  • Skilled in synthesizing audit results to drive education and process improvement
  • Preferred Key Skills and Abilities :

  • Prior experience in a CDI QA, audit, or compliance oversight role
  • Successful track record in outpatient coding and billing through previous experience
  • Self-directed and solution oriented
  • Strong understanding of value-based care principles, particularly as they relate to the impact of clinical documentation and coding on risk adjustment payment models in value-based contracts
  • Strong understanding of outpatient coding and billing
  • Solution-oriented individual who can execute tactical continuous quality improvement work to deliver results in value-based contracts
  • Excellent communicator who can articulate the impact of documentation and diagnosis initiatives to Aledade ACO member practices and their key staff (e.g., office managers, practice billers, etc.), and internally within the company.
  • Ability to work collaboratively across Aledade clinical and non-clinical teams to gain buy-in and implement key documentation improvement initiatives
  • References demonstrating high degree of integrity and professional accountability