CDI Technical Advisor

Site: Mass General Brigham Incorporated

Mass General Brigham relies on a wide range of professionals including doctors nurses business people tech experts researchers and systems analysts to advance our mission. As a not-for-profit we support patient care research teaching and community service striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

General Overview

The CDI Technical Advisor reports to the Director CDI Operations and conducts advanced clinical documentation reviews for inpatient encounters to ensure accuracy and compliance with MGB standards and regulatory requirements. This position provides quality assurance for primary CDI reviews supports accurate code assignment and DRG validation and ensures optimal reimbursement and data quality for CMS and commercial payors.

Principal Duties and Responsibilities

Identify discrepancies or missed opportunities in clinical documentation that impact severity of illness risk of mortality DRG assignment and reimbursement through second level CDI reviews

Escalate complex cases to the CDI leadership team or physician advisors as needed

Demonstrate service-line expertise for targeted DRG assignment validation

Facilitate communication between vendor supported primary CDI staff and Coding

Perform pre and post bill audits to ensure accurate reflection of the patients clinical picture and acuity specifically concentrating on CMS and commercial payor impact

Provide oversight and quality assurance for the CDI and Coder reconciliation process

Manage and track retro-query coding requests to CDI

Support provider query escalation process

Identify monitor and communicate trends and/or gaps in clinical documentation and/or CDI practices

Maintain up-to-date knowledge of inpatient coding guidelines CDI practices CMS/OIG regulatory changes and AHA Coding Clinic

Meet or exceed MGB CDI Technical Advisor key performance indicators

Use the Mass General Brigham values to govern decisions actions and behaviors. These values guide how we get our work done: Patients Affordability Accountability & Service Commitment Decisiveness Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion Integrity & Respect Learning Continuous Improvement & Personal Growth Teamwork & Collaboration

Other duties as assigned

• Registered Nurse (RN) Advanced Practice Clinician (NP/PA) or other clinically licensed professional required
• 5-7 years of acute medical/surgical care experience required
• 3-5 years of clinical documentation improvement experience required
• Certification in Clinical Documentation preferred

Knowledge Skills and Abilities

• Knowledgeable about current CDI industry trends

• Deep knowledge of clinical disease processes and inpatient care delivery

• Proactive in researching and resolving clinical and CDI questio

• Skilled at drafting clear credible and compliant clinical queries

• Proficient in CDI software to document track report outcomes and collaborate with coding professionals

• Advanced understanding of MS-DRG/APR-DRG logic SOI/ROM methodology and CC/MCC assignment

• Recognizes principal diagnosis sequencing opportunities and applies Official Coding Guidelines consistently

• Strong analytical critical thinking and clinical reasoning skills

• Strong attention to detail with commitment to accuracy and compliance

• Excellent written and verbal communication skills

• Self-driven able to prioritize tasks and adapt quickly to change

• Dedicated to continuous learning and professional growth

• Team-oriented with strong collaboration skills

Remote

399 Revolution Drive

40

Regular

Day (United States of America)

Pay Range

$78000.00 - $113453.60/Annual

Grade

7

At Mass General Brigham we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive and any offer extended will take into account your skills relevant experience if applicable education certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however it does not encompass all elements contributing to your total compensation addition to competitive base pay we offer comprehensive benefits career advancement opportunities differentials premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religious creed national origin sex age gender identity disability sexual orientation military service genetic information and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process to perform essential job functions and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973 the Vietnam Veterans Readjustment Act of 1974 and Title I of the Americans with Disabilities Act of 1990 applicants who require accommodation in the job application process may contact Human Resources at .

Mass General Brigham Competency Framework