About the role
Job Type: Contractor
Location: Remote
Job Overview We are seeking experienced Hospitalist Physicians to contribute their medical expertise to a project focused on inpatient care, clinical documentation, and medical record quality . In this role, you will review clinical records, evaluate documentation for accuracy and completeness, and apply your clinical expertise to support high-quality medical data and AI training.
The ideal candidate has recent inpatient or hospitalist experience, strong clinical documentation knowledge, and the ability to consistently apply established review standards.
Key Responsibilities
- Review medical records, including FHIR data and clinical notes, for AI training and quality evaluation.
- Verify that clinical information, findings, and claims are supported by the available medical record.
- Review inpatient documentation, including History of Present Illness (HPI), Past Medical History (PMH), assessments, and treatment plans.
- Evaluate clinical documentation for accuracy, completeness, and consistency.
- Identify missing, incorrect, conflicting, or unsupported information in medical records.
- Apply established rubrics, guidelines, and review criteria consistently across cases.
- Provide clear and concise feedback on clinical documentation and data quality.
- Support quality assurance processes by identifying potential issues and inconsistencies.
- Communicate effectively with the project team regarding findings, questions, and complex cases.
- Maintain high standards of accuracy, consistency, and attention to detail throughout the review process.
Required Qualifications
- MD or DO degree.
- Board certification in Internal Medicine, Pediatrics, or Hospital Medicine.
- Current or recent inpatient/hospitalist experience within the last 2 years.
- Strong understanding of inpatient documentation and hospital workflows.
- Experience reviewing clinical notes and medical records.
- Ability to interpret FHIR-based clinical data and structured medical records.
- Strong understanding of HPI, PMH, assessments, plans, and other inpatient documentation.
- Excellent attention to detail and ability to identify discrepancies in clinical information.
- Ability to follow defined rubrics and quality standards consistently.
- Strong written and verbal communication skills.
Preferred Qualifications
- Experience with chart review or clinical documentation review.
- Experience with clinical documentation improvement (CDI).
- Experience with utilization review, medical coding, or healthcare quality assurance.
- Familiarity with electronic health records and structured clinical data.
- Experience working across multiple inpatient services or specialties.
- Previous experience reviewing healthcare data for quality, accuracy, or compliance.
- Comfortable working independently in a remote environment.
Core Skills
- FHIR Records
- History of Present Illness (HPI)
- Past Medical History (PMH)
- Clinical Documentation Review
- Inpatient / Hospitalist Experience
- Quality Assurance
- Medical Record Review
- Clinical Judgment
- Healthcare Data Quality
- Rubric-Based Evaluation
- Attention to Detail
- Written and Verbal Communication
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