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CDI Technical Advisor

Mass General Brigham (Enterprise Services)
United States, Massachusetts, Somerville
399 Revolution Drive (Show on map)
Mar 12, 2026
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 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 an accurate reflection of the patient's clinical picture and acuity, with a specific focus on the impact of CMS and commercial payors. Provide oversight and quality assurance for the CDI and Coder reconciliation process. Manage and track retro-query coding requests to CDI. Support the 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. Education Associate's Degree Nursing, Advanced Degree Nurse Practitioner or Physician Assistant preferred Licenses and Credentials Active and Current Registered Nurse License, Nurse Practitioner License or Physician Assistant License required Experience 5 - 7 years of acute medical/surgical care experience required 3 - 5 years of clinical documentation improvement experience required Knowledge, Skills and Abilities Strong knowledge of clinical documentation standards, coding guidelines, and regulatory requirements. Excellent analytical and problem-solving skills to assess and improve documentation practices. Effective communication and interpersonal skills to collaborate with physicians, coders, and other staff. Proficiency in health information systems and electronic medical record platforms. Ability to provide education and training to clinical and administrative teams. Detail-oriented with strong organizational skills to manage multiple tasks and meet deadlines. 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.