CDI Team Lead

Job Description

JOB DESCRIPTION

Clinical Documentation Improvement (CDI) Team Leader

Manila Office, Philippines

Job Title

CDI Team Leader

Department

Clinical Documentation Improvement (CDI)

Location

Manila, Philippines

Reports To

CDI Manager / Director of Revenue Cycle

Employment Type

Full-Time, Regular

Work Arrangement

On-site / Hybrid (as applicable)

Salary Band

Competitive — commensurate with experience

POSITION SUMMARY

The Team Leader serves as the primary point of escalation for clinical queries, quality reviews, and team performance, and acts as a key liaison between the Manila CDI team and onshore/offshore stakeholders.

1. Team Supervision & Leadership

• Supervise a team of CDI Specialists, providing day-to-day guidance, coaching, and performance feedback
• Monitor daily work queues, productivity metrics, and query volumes to ensure service level targets are met
• Conduct regular 1-on-1s, team huddles, and performance reviews
• Assist in onboarding, training, and skills development of new team members
• Foster a culture of continuous learning, accountability, and quality excellence

1. Clinical Documentation Review

• Oversee concurrent and retrospective review of inpatient and outpatient medical records
• Ensure accurate identification of principal and secondary diagnoses, procedures, and HCC (Hierarchical Condition Category) risk scores
• Validate appropriate assignment of MS-DRG, APR-DRG, and ICD-10-CM/PCS codes in collaboration with coding teams
• Review and approve clinical queries drafted by team members prior to physician submission where required
• Perform quality audits on team query rates, query response rates, and documentation capture rates

1. Physician Query Management

• Guide team in drafting compliant, non-leading physician queries in line with AHIMA and ACDIS standards
• Track query response rates and escalate unresolved or pending queries as appropriate
• Build collaborative relationships with physicians and clinical staff to improve documentation habits

1. Quality Assurance & Compliance

• Monitor team adherence to CDI program policies, coding guidelines, and regulatory requirements
• Conduct internal audits and identify documentation gaps, trends, and education opportunities
• Ensure compliance with HIPAA, PHI handling protocols, and client-specific data security requirements
• Prepare and present quality and productivity reports to CDI Manager/Director

1. Collaboration & Stakeholder Engagement

• Serve as the Manila-based point of contact for onshore CDI, coding, and HIM leadership
• Participate in cross-functional meetings with Coding, Case Management, and Revenue Integrity teams
• Coordinate with US-based CDI leadership on program goals, updates, and escalations
• Support implementation of CDI technology tools (e.g., 3M, Nuance/Optum CDI solutions)

1. Reporting & Documentation

• Maintain accurate records of query activity, team productivity, and case review outcomes
• Generate weekly and monthly dashboards and trend analyses for management reporting
• Document process improvements and maintain up-to-date SOPs for CDI workflows

QUALIFICATIONS & REQUIREMENTS

• Bachelor's degree in nursing, Physical Therapy, or Allied Health Sciences (required)
• Medical degree (MD) is an advantage but not required
• Formal training or certification in Clinical Documentation Improvement preferred

• CCDS – Certified Clinical Documentation Specialist (ACDIS)
• CDIP – Clinical Documentation Improvement Practitioner (AHIMA)
• CCS – Certified Coding Specialist or CIC – Certified Inpatient Coder

• Minimum 5-7 years of CDI experience in a US-based healthcare or BPO/KPO environment
• At least 2-3 years in a supervisory, lead, or senior CDI role
• Demonstrated experience with ICD-10-CM/PCS coding guidelines and DRG optimization
• Experience working with CDI software platforms (e.g., Epic Guesthouse, Solventum CDI Collaborate, 3M 360 Encompass, Nuance CDI, Optum CDI Advisor Etc…)

• Strong understanding of US healthcare revenue cycle, medical coding, and clinical terminology
• Proficiency in interpreting medical records, lab results, radiology reports, and operative notes
• Excellent written and verbal communication skills in English
• Strong leadership, coaching, and conflict-resolution abilities
• High attention to detail, critical thinking, and analytical mindset
• Proficient in Microsoft Office Suite (Excel, Word, Outlook, Teams)

KEY PERFORMANCE INDICATORS (KPIs)

KPI Metric

Target

Query Rate

≥ 25% of eligible cases

Physician Query Response Rate

≥ 85% within 48 hours

Query Agreement Rate

≥ 75%

Documentation Capture Rate

Month-over-month improvement

Team Productivity (cases/day)

Per program benchmarks

Quality Audit Score

≥ 95% accuracy

Team Attrition Rate

• Work hours aligned with US Eastern or Central time zone (night shift / shifting schedule)
• Work schedule: Monday to Friday; weekend coverage may be required based on client needs
• Occasional overtime or on-call support during peak periods or system go-lives
• Comfortable working in a BPO/KPO environment with strict data privacy and security protocols

• Competitive base salary aligned with CDI industry benchmarks in the Philippines
• Professional development support — certification exam reimbursement and training budget