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CDI Technical Advisor

Mass General Brigham · Somerville, Massachusetts, US

Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech expert...

Job description

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: The position reports to the senior leadership 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. Essential Functions: - Identify discrepancies or missed opportunities in clinical documentation that impact the severity of illness, risk of mortality, DRG assignment, and reimbursement through second-level CDI reviews. - Escalate complex cases to the C...