{"id":3646944,"url":"https://alion.io/job/guidehouse-second-level-reviewer-clinical-documentation-integrity-2","title":"Second Level Reviewer-Clinical Documentation Integrity","company":{"id":4179,"name":"Guidehouse","domain":"guidehouse.com","url":"https://alion.io/company/guidehouse","size_band":"1001-5000","is_staffing_agency":false,"employer_type":"services","is_intermediary":false,"listed_via":null,"ats_vendor":"Workday","truth_index":{"grade":"B","score":81,"open_postings":111,"ghost_share":0,"stale_share":0.748,"repost_share":0.009,"time_to_fill_p50_days":29,"computed_at":"2026-11-05T05:54:30Z"}},"role":"Education","role_family":"Education","seniority":"middle","employment_type":"full_time","work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"board_field","remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Greenville, United States"],"countries":["US"],"hiring_countries":["US"],"hiring_countries_total":1,"salary":{"min":89000,"max":148000,"currency":"USD","period":"year","gross":null,"usd_annual":148000},"salary_estimate":null,"experience_years_min":4,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"HIPAA","optional":false}],"status":"live","first_seen_at":"2026-11-02T23:10:38Z","employer_posted_date":"2026-11-02","last_verified_at":"2026-11-06T01:03:33Z","board_verified":true,"closed_at":null,"days_open":3,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":3},"description":"Job Family:\nCDI SpecialistTravel Required:\nNoneClearance Required:\nNoneWhat You Will Do:\nSecond level reviewer responsibilities include comprehensive, clinical chart reviews to ensure the most accurate reflection of the patient’s care and diagnosis following Official Coding Guidelines, Coding Clinics, and Client policies.\nThe Clinical Documentation Integrity (CDI) Second Level Reviewer will collaborate closely with the CDI team, Physician Advisors, Providers, Clinicians, Coding Educator, Coding Quality Auditors, Case Managers and Quality Department to assure documentation is clinically appropriate, accurately reflects the severity of illness and risk of mortality for the patient and is reflective of current CMS or other regulatory standards. Applies the Association of Clinical Documentation Integrity Specialist (ACDIS) best practices for writing clinical documentation integrity clarifications (see Achieving a Compliant Query) and follows the CDI Code of Ethics. Collaborates with CDI Management/Educator to identify opportunities for education with CDI team, Coding, Providers and/or other ancillary staff to improve the overall quality and completeness of documentation.\nThe second level review role is dynamic, requiring adaptation to various clinical and administrative needs. This flexibility is essential for effectively addressing the evolving challenges in clinical documentation, ensuring the accuracy and compliance of patient records. The incumbent will navigate multiple responsibilities with agility, participating in diverse projects and initiatives that enhance documentation quality and patient care standards.\nUnderstands quality risk models and apply them during secondary reviews.\nCollaborate closely with Coders, Coding Educators, Coding Quality Auditors, Case managers, Quality Department and Providers to assure documentation is clinically appropriate, accurately reflects the severity of illness and risk of mortality for the patient and is reflective of current CMS or other regulatory standards.\nDemonstrates excellent verbal and written communication skills, crucial for effective interaction with healthcare professionals and the creation of compliant queries.\nActs as a liaison between the Coding Department and the Clinical Documentation Specialist to reconcile discrepancies in code and/or DRG assignment.\nExhibits adeptness in quickly learning and adapting to new technologies. Proficient in utilizing EHR systems, CDI software, and encoders to optimize workflow and boost productivity.\nApply the principles of clinical validation and ensure that queries are compliant with AHIMA guidelines.\nDuties:\nAnalyzes and interprets clinical data to identify gaps, inconsistencies, and/or opportunities for improvement in the clinical documentation and queries the provider using concurrent query process following ACDIS/AHIMA Guidelines for Compliant Query Writing.\nDemonstrated ability to collaborate with the Quality Department on annual quality initiatives. \nCompletes comprehensive, clinical secondary reviews of targeted patient populations to include cases with DRG and/or code discrepancies; mortality reviews to ensure documentation supports risk of mortality; hospital acquired conditions (HACs), patient safety indicators (PSIs) or other top priority diagnosis as identified by the client for potential missed opportunities to clarify documentation or clinically validate a diagnosis.\nConsistently meet second level review productivity, quality, and turnaround expectations, including mailbox inquiries and mortality reviews, to support Guidehouse client metrics.\nActs as a liaison between the Coding Department and the Clinical Documentation Specialist to reconcile discrepancies in code and/or DRG assignment.\nCollaborates with CDI educator/quality auditor when educational needs are identified from second level reviews\nDocument and track the results of secondary reviews, sharing information during formal and informal education sessions to all stakeholders (CDI, Leadership, Physicians), via by engaging in collaborative interactions with physicians and other clinicians to enhance understanding of CDI program goals.\nCollaborative interaction with physicians and/or other clinicians to enhance understanding of the CDI program goals.\nPerform impartial audits of front-line CDI documentation using Guidehouse criteria, provide professional feedback and mentorship, and escalate unresolved disagreements through appropriate leadership channels.\nParticipate in departmental and hospital committees, assigned task forces, and service line assignment meetings as requested.\nContribute to a positive and collaborative working environment.\nPerform other duties as assigned.\nComply with HIPAA and code of conduct policies.\nWhat You Will Need:\nRequires a University Degree and minimum 4-6 years of prior relevant experience; (Relevant experience may be substituted for formal education or advanced degree)\nCurrently licensed as a Registered Nurse, MD or MD equivalent OR Credentialed Medical Coder through AHIMA with current CCS, RHIA or RHIT credential and CDIP or CCDS\n4- 6 years previous relevant experience in clinical documentation, or CDI second level review or inpatient coding quality review and/or DRG validation with a strong understanding of disease processes, clinical indications and treatments; provider documentation requirements to reflect severity of illness, risk of mortality and support the diagnosis/procedures performed for accurate clinical coding and billing according the rules of Medicare, Medicaid, and commercial payors as well as a solid understanding of hospital acquired conditions (HAC’s) , patient safety indicators (PSI’s) and mortality models\nMust maintain credentials while employed\nWhat Would Be Nice to Have:\nCCDS, CCS or CDIP certification\nStrong clinical and critical thinking skillset\nExperience with encoder and DRG assignments (MS and APR)\nMaintains working knowledge of Official Coding Guidelines, Coding Clinic and federal updates to the DRG system\n#LI-DNI\nThe annual salary range for this position is $89,000.00-$148,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. What We Offer:\nGuidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.\nBenefits include:\nMedical, Rx, Dental & Vision Insurance\n\nPersonal and Family Sick Time & Company Paid Holidays\n\nPosition may be eligible for a discretionary variable incentive bonus\n\nParental Leave\n\n401(k) Retirement Plan\n\nBasic Life & Supplemental Life\n\nHealth Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts\n\nShort-Term & Long-Term Disability\n\nTuition Reimbursement, Personal Development & Learning Opportunities\n\nSkills Development & Certifications\n\nEmployee Referral Program\n\nCorporate Sponsored Events & Community Outreach\n\nEmergency Back-Up Childcare Program\n\nAbout Guidehouse\nGuidehouse is an Equal Opportunity Employer-Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.\nGuidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.\nIf you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.\nAll communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or . Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.\nIf any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact . Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.\nGuidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.","description_format":"text","description_chars":9209,"description_truncated":false,"requirements":{"experience_years_min":4,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":null,"security_clearance":false,"languages":[]},"benefits":["Parental leave","Retirement plans","Vision insurance"],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Digital Government","IT Consulting & Digital Transformation","Management Consulting"],"lifecycle":[{"event":"open","at":"2026-11-02T23:10:38Z"}],"visa":[{"country":"US","licensed_sponsor":true,"evidence":"H-1B filings in 12 months: 24 · green card filings: 14","filings_12m":24,"filings_prev_12m":23,"green_card_filings_12m":14,"median_offered_wage_usd":132500,"route":null,"cap_exempt":false,"checked_at":"2026-10-29T16:27:21+00:00","sources":["US Department of Labor: LCA disclosure data (H-1B, H-1B1, E-3)","US Department of Labor: PERM disclosure data (green cards)"],"filings_for_role_12m":0}],"liveness":{"score":63,"band":"ok","label":"Likely open","p_open":1,"p_active":0.632,"p_room":1,"age_days":2,"expected_fill_days":29,"reasons":["conf:2","stale_co","velocity","win:early","comp:brand"],"computed_at":"2026-11-05T05:54:30Z"},"pay":{"stated_usd_annual":148000,"is_top_pay":true},"html_url":"https://alion.io/job/guidehouse-second-level-reviewer-clinical-documentation-integrity-2","json_url":"https://alion.io/job/guidehouse-second-level-reviewer-clinical-documentation-integrity-2.json","meta":{"generated_at":"2026-11-06T03:37:57Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":6056,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-11-07T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":4179},"rest":"https://alion.io/mcp/rest/get_company?id=4179"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fguidehouse-second-level-reviewer-clinical-documentation-integrity-2"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fguidehouse-second-level-reviewer-clinical-documentation-integrity-2"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fguidehouse-second-level-reviewer-clinical-documentation-integrity-2"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/guidehouse-second-level-reviewer-clinical-documentation-integrity-2\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fguidehouse-second-level-reviewer-clinical-documentation-integrity-2"}],"agent":{"mcp":"https://alion.io/mcp/jobs","mcp_open":"https://alion.io/mcp/open","next":[{"tool":"get_job","arguments":{"id":3646944}},{"tool":"search_jobs","arguments":{"company":"guidehouse.com","detail":"compact"}},{"tool":"match_people","arguments":{"job_id":3646944},"note":"people open to offers who fit this vacancy"}],"note":"The same data through MCP tools: https://alion.io/mcp/open needs no sign-in (compact searches, postings, people); https://alion.io/mcp with an Alion account has everything. Docs: https://alion.io/developers"}}