Medical Coding Quality Auditor - Hybrid

2 Months ago • 7 Years +

Auditing

Job Description

Neolytix is a tech-enabled healthcare services company focused on delivering impactful solutions across medical billing, credentialing, contact center support, virtual assistant staffing, and AI-driven automation. We support healthcare provider organizations across the U.S. with a focus on improving operational efficiency, compliance, and patient experience. We are expanding our Clinical Documentation Integrity (CDI) services and are looking for a highly experienced, entrepreneurial CDI Leader who can build and scale this function — with a focus on developing and managing an offshore delivery team. This is a player-coach role for a Subject Matter Expert (SME) in Clinical Documentation Integrity who will create and implement CDI standards, collaborate with clients, design scalable service delivery processes, hire and lead offshore CDI specialists, and establish metrics for continuous improvement. You will be instrumental in the strategic growth of this service line.

Good To Have:

Experience in setting up CDI programs from the ground up
Familiarity with AI-enabled CDI tools, clinical NLP solutions, or EHR-integrated documentation improvement software
Prior experience in a healthcare BPO or MSO environment

Must Have:

Create and implement CDI standards and best practices
Collaborate with clients to understand documentation challenges and quality improvement needs
Design scalable service delivery processes for offshore team execution
Hire, train, and lead offshore CDI specialists
Establish metrics and governance for continuous improvement and regulatory compliance
Develop CDI protocols, policies, and documentation improvement strategies
Lead implementation of CDI services for new clients
Ensure adherence to industry standards (AHIMA, ACDIS) and payer documentation requirements
Build scalable workflows and SOPs for offshore CDI operations
Select, train, and mentor offshore CDI team members
Define KPIs and build performance dashboards to monitor team effectiveness
Act as the SME on all client interactions regarding documentation improvement
Collaborate with physicians, HIM staff, coders, and revenue cycle teams
Provide education and feedback sessions to clients and internal teams
Establish quality audit programs to ensure CDI work meets expectations
Stay abreast of CMS, HCC, risk adjustment, and inpatient/outpatient CDI changes
Contribute to technology adoption for CDI (e.g., NLP tools, clinical data insights)

Perks:

Opportunity to build a CDI center of excellence from the ground up
Work in a highly entrepreneurial environment that values innovation and ownership
Contribute to the transformation of clinical documentation for healthcare providers nationwide
Be part of a growing, tech-enabled healthcare services company with global operations
Competitive base salary + performance bonuses
Remote work flexibility with occasional travel
Health, dental, and retirement benefits
Opportunity to grow into a senior leadership position
Competitive compensation package
Hybrid work flexibility (mix of remote and in-office)
Collaborative, mission-driven team culture
Opportunities for career development and CDI certification support
Comprehensive benefits including HMO, Leave Credits

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About Neolytix

We are expanding our Clinical Documentation Integrity (CDI) services and are looking for a highly experienced, entrepreneurial CDI Leader who can build and scale this function — with a focus on developing and managing an offshore delivery team.

Role Overview

This is a player-coach role for a Subject Matter Expert (SME) in Clinical Documentation Integrity who can:

Create and implement CDI standards and best practices
Collaborate with clients to understand documentation challenges and quality improvement needs
Design scalable service delivery processes to be executed by an offshore team
Hire, train, and lead offshore CDI specialists
Establish metrics and governance for continuous improvement and regulatory compliance

You will be the foundational leader of this service line and instrumental in its strategic growth.

Key Responsibilities

CDI Program Design & Governance

Develop CDI protocols, policies, and documentation improvement strategies for provider organizations
Lead implementation of CDI services for new clients, including documentation audits, gap analysis, and recommendations
Ensure adherence to industry standards (AHIMA, ACDIS) and payer documentation requirements

Operational Leadership

Build scalable workflows and SOPs for offshore CDI operations
Select, train, and mentor offshore CDI team members to ensure service quality
Define KPIs and build performance dashboards to monitor team effectiveness and documentation impact

Client Engagement & SME Support

Act as the SME on all client interactions regarding documentation improvement strategies
Collaborate with physicians, HIM staff, coders, and revenue cycle teams to align documentation with coding and compliance
Provide education and feedback sessions to clients and internal teams

Compliance & Quality

Establish quality audit programs to ensure CDI work meets client expectations and regulatory standards
Stay abreast of CMS, HCC, risk adjustment, and inpatient/outpatient CDI changes and best practices
Contribute to technology adoption for CDI (e.g., NLP tools, clinical data insights)

Qualifications Required

7+ years of progressive experience in Clinical Documentation Improvement, with experience across both inpatient and outpatient settings
Deep understanding of CDI workflows, risk-adjusted payment models (e.g., HCC), and coding/documentation best practices
Experience working with or leading remote/offshore teams
CCDS, CDIP, RHIA, RHIT, or relevant certifications strongly preferred
Experience collaborating directly with providers and RCM teams
Excellent communication and training skills

Preferred

Experience in setting up CDI programs from the ground up
Familiarity with AI-enabled CDI tools, clinical NLP solutions, or EHR-integrated documentation improvement software
Prior experience in a healthcare BPO or MSO environment

Why Join Neolytix?

Help build a CDI center of excellence from the ground up
Work in a highly entrepreneurial environment that values innovation and ownership
Contribute to the transformation of clinical documentation for healthcare providers nationwide
Be part of a growing, tech-enabled healthcare services company with global operations

Compensation & Benefits

Competitive base salary + performance bonuses
Remote work flexibility with occasional travel
Health, dental, and retirement benefits
Opportunity to grow into a senior leadership position as the CDI service line scales