CDI Specialist at Mercor

CDI Specialist | $50–$150/hr | Worldwide Remote

Join Mercor as a Clinical Documentation Integrity (CDI) Specialist and apply your inpatient coding and documentation expertise to evaluate AI-driven CDI workflows. This flexible, remote contractor role is ideal for experienced CDI professionals, inpatient coders, or HIM specialists looking to contribute to cutting-edge healthcare AI development.

What You'll Do

• Review AI-agent attempts at realistic CDI and coding tasks, judging whether each disposition is correct and adequately supported by the clinical record.
• Confirm that work is actually completed and recorded — codes changed, queries sent, holds placed, DRGs recomputed, and CDI reviews filed — not merely described.
• Identify fabricated or overstated work, including cited labs, documents, or prior encounters that don't exist in the record, or DRG figures not produced by the grouper.
• Assess completeness and determine whether the correct action was applied: code fix, query, clinical-validation query, or leave-alone.
• Write clear, specific agree/disagree rationales for each AI attempt reviewed.

Clinical Documentation Knowledge Required

• Coding & Pre-Bill Cycle: ICD-10-CM/PCS assignment, POA reporting, DRG assignment and reimbursement cycle, concurrent and retrospective review, DRG reconciliation, and coded-diagnosis tie-out to source documentation.
• Judgment & Evaluation: CC/MCC impact and DRG movement; principal-diagnosis sequencing; dollar and quality impact of code changes.
• Clinical Standards & Criteria: Applying KDIGO AKI staging, sepsis, respiratory failure, malnutrition, and CKD staging criteria; UHDDS reporting rules; clinical validation of diagnoses.
• Query & Compliance Discipline: AHIMA/ACDIS-compliant, non-leading query construction; understanding when a query is required versus when specificity is already documented.
• Documentation & Evidence: Query vs. CDI-review vs. note standards; hold/pending mechanics; evidence provenance — only citing data actually present in the record.
• Tools: CAC/CDI platforms (e.g., Dolbey Fusion, 3M 360 Encompass, Nuance/Optum360), DRG groupers, and EHR systems such as Epic.

Requirements

• 2+ years of professional experience in inpatient hospital CDI (specialist or leadership), inpatient DRG coding/auditing, or clinical-documentation denial management.
• Current or recent hands-on work under ICD-10-CM/PCS and MS-DRGs.
• Ability to identify unsupported diagnoses, leading queries, missed CC/MCCs, or rubber-stamped accounts on sight.
• Credentials such as CCDS, CDIP, CCS, RHIA/RHIT, or RN with CDI experience (or equivalent) preferred.
• Comfort reading full clinical records — H&Ps, consults, progress notes, discharge summaries, labs, and flowsheets — within CAC/CDI software environments.