CDI Technical Advisor

Mass General Brigham (Enterprise Services)
United States, Massachusetts, Somerville
399 Revolution Drive (Show on map)
Oct 15, 2025
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 patient's 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 Mass General Brigham Incorporated is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. 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.