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Job description
Role Overview Review inpatient clinical documentation to support high-quality assessment of hospital-based care. You will evaluate H&Ps, progress notes, and discharge summaries for clinical accuracy, completeness, and fidelity to the patient encounter, applying nuanced clinical judgment in written and verbal formats.
Key Responsibilities Assess inpatient documentation for accuracy, completeness, and clinical appropriateness.
Adjudicate ambiguous or conflicting clinical information and provide clear, well-reasoned determinations.
Identify clinically significant errors, omissions, and inconsistencies, then categorize findings by severity.
Apply structured review rubrics and quality criteria consistently across cases.
Document concise written rationales for adjudication decisions.
Help refine review guidelines and quality standards.
Qualifications MD or DO with board certification in Internal Medicine or Family Medicine.
At least 5 years of attending hospitalist experience, or demonstrated leadership of documentation audit programs.
Strong expertise in inpatient medicine, clinical documentation, clinical adjudication, and error detection.
Deep familiarity with inpatient documentation standards and hospital quality-assurance processes.
Experience with clinical documentation improvement programs is preferred.
Understanding of the effects of documentation on coding, billing, and compliance.
Ability to work independently in a remote environment.
Work Terms Remote contract engagement.
Compensation $100 to $150 per hour.
Application Process Apply by email or through an available application option. Submitting an application acknowledges the candidate terms and privacy policy.
Who can apply
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