CDI Query Specialist

Description

The CDI Query Writer develops and distributes compliant provider queries that clarify clinical documentation and support an accurate representation of each patient's condition, severity of illness, risk of mortality, diagnoses, and procedures. This role evaluates query requests, applies clinical documentation integrity and coding guidelines, and collaborates with physician reviewers and other stakeholders to ensure queries are clear, clinically supported, appropriately directed, and compliant with applicable standards.

Responsibilities

Query Development and Distribution

Review clinical indicators and query recommendations received from physician reviewers, DRG Integrity Specialists, and other authorized stakeholders.

Develop clear, concise, non-leading, and clinically supported provider queries.

Direct queries to the appropriate client provider or other designated recipient.

Apply proper grammar, punctuation, medical terminology, and professional writing standards.

Ensure queries accurately address documentation opportunities related to diagnoses, procedures, severity of illness, risk of mortality, and final code assignment.

Clarify incomplete or potentially ambiguous query requests before distribution.

Compliance and Quality

Prepare queries in accordance with applicable AHIMA and ACDIS guidance, AHA Coding Clinic guidance, ICD-10 coding conventions, and Accuity and client policies.

Ensure supporting clinical documentation and indicators are appropriately reflected in each query.

Apply federal and state coding and reimbursement requirements as relevant to assigned work.

Maintain established quality, accuracy, compliance, and productivity standards.

Identify and escalate potential compliance, clinical validation, or documentation concerns through appropriate channels.

Cross-Functional Collaboration

Collaborate with physician reviewers, DRG Integrity Specialists, CDI professionals, coding professionals, and operational leaders to resolve questions and reduce the risk of misinterpretation.

Maintain professional, service-oriented working relationships with internal teams and client stakeholders.

Communicate effectively in a fully remote environment through approved technology and communication channels.

Support consistent interpretation and application of query-writing standards across assigned accounts.

Systems and Documentation

Accurately enter required information into Accuity tracking, workflow, and reporting tools.

Navigate multiple electronic medical record systems, client platforms, and internal applications.

Maintain complete and timely documentation of query activity and reportable criteria.

Use Microsoft Word, Windows-based applications, and other assigned technology effectively.

Professional Development

Participate in required education related to coding, CDI, clinical validation, query compliance, client requirements, and internal policies.

Maintain current knowledge of changes to coding guidelines, query practices, and relevant regulatory requirements.

Incorporate feedback from quality reviews, audits, and coaching into ongoing work.

Other Duties as Assigned

Perform other job-related duties as assigned to support departmental and organizational objectives.

Requirements

Qualifications

Education and Credentials

At least one of the following educational backgrounds is required:

Foreign medical graduate

Associate degree in Nursing

Bachelor's degree in Nursing

Bachelor's degree in Health Information Management

Another related degree approved by management

At least one of the following credentials is required:

MD, DO, RN, BSN, CDIP, CCS, CCDS

Experience

Minimum of three years of clinical work experience.

Minimum of two years of recent inpatient clinical documentation integrity experience.

Demonstrated experience applying ICD-10 coding guidelines, medical terminology, and inpatient documentation concepts.

Experience developing or reviewing compliant provider queries.

Experience working with electronic medical record systems and data or workflow tracking tools.

Experience managing multiple cases, systems, or work queues while meeting defined quality and productivity expectations.

Core Competencies

Written Communication: Produces precise, professional, grammatically correct queries that are easy for providers to understand and answer.

Clinical and Analytical Judgment: Evaluates clinical indicators, documentation, and query recommendations to determine whether clarification is supported and appropriate.

Attention to Detail: Consistently identifies documentation nuances, inconsistencies, and potential compliance concerns.

Collaboration: Works productively with physician reviewers, CDI professionals, coding teams, operational leaders, and client stakeholders.

Problem Solving: Resolves ambiguous or incomplete requests and escalates complex issues appropriately.

Organization and Prioritization: Manages multiple cases, systems, and deadlines without sacrificing quality.

Accountability: Takes ownership of assigned work and meets established productivity, quality, and compliance expectations.

Adaptability: Learns new client requirements, technologies, workflows, and regulatory guidance.

Remote-Work Effectiveness: Works independently, remains focused, communicates proactively, and maintains reliable performance in a fully remote environment.

Technology Proficiency: Efficiently uses multiple screens, electronic medical records, tracking systems, Microsoft Word, and Windows-based applications.

Professionalism: Maintains discretion, sound judgment, and service-oriented relationships across internal and external interactions.