Clinical Documentation Integrity (CDI) Leader

About this role

Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems. We are seeking experienced Clinical Documentation Integrity (CDI) managers and leaders to evaluate AI tools designed to enhance clinical documentation accuracy and coding integrity workflows. Your expertise in DRG optimisation, HCC risk adjustment, physician query management, and clinical documentation best practices will directly inform AI systems that improve documentation quality, compliance, and revenue integrity. **Responsibilities** - Lead clinical documentation integrity programs for inpatient and/or outpatient settings, overseeing concurrent and retrospective review workflows. - Evaluate AI-generated clinical documentation improvement suggestions, physician queries, and coding recommendations for clinical accuracy and compliance. - Conduct and review clinical documentation to ensure accurate capture of diagnoses, procedures, severity of illness, and risk of mortality. - Develop and manage physician query processes in alignment with AHIMA and ACDIS guidelines. - Monitor CDI program KPIs including query response rates, CC/MCC capture rates, case mix index, and DRG accuracy. - Collaborate with coding, compliance, and clinical teams to address documentation gaps and improve query processes. - Provide education to physicians and clinical staff on documentation requirements and best practices. - Ensure compliance with Official Coding Guidelines, CMS regulations, and payer-specific requirements. - Annotate AI outputs and provide structured clinical feedback to support AI training datasets. **Requirements** - 5+ years of experience in clinical documentation integrity or improvement, with at least 2 years in a manager or leadership role. - Deep knowledge of MS-DRG methodology, CC/MCC hierarchies, and ICD-10-CM/PCS coding guidelines. - Expertise in physician query management per AHIMA and ACDIS compliant