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Clinical Documentation Specialist
Pay68.00 - 89.00 / hour
LocationRoslyn/New York
Employment typeOther
This job is now closed
Job Description
- Req#: 57048
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $89.00 per hour
- Generous benefits packages including tuition assistance and a defined benefit pension plan
- Opportunity for professional and educational growth within the organization
- Collaborative work environment promoting teamwork across departments
- Chance to make a significant impact on patient care and clinical documentation accuracy
What to Expect (Job Responsibilities):
- Improve the quality and completeness of clinical documentation within inpatient records
- Perform concurrent reviews and facilitate modifications to reflect illness severity and mortality risk
- Analyze clinical data to identify documentation gaps and query providers for compliance
- Validate DRG assignment with medical record documentation and ICD-10 guidelines
- Educate physicians on the specificity of documentation for conditions and complications
What is Required (Qualifications):
- Minimum of 5 years of recent staff nurse clinical acute care inpatient experience required; critical care experience preferred
- Education: Registered Nurse (BSN preferred), Nurse Practitioner, or Physician Assistant licensed in the State of New York
- Completion of ICD-10-CM/PCS coding class within 6 months of employment
- CCDS certification required within 2 years of hire date
- Chart review skills with ICD-10-CM/PCS experience strongly preferred
How to Stand Out (Preferred Qualifications):
- Experience in clinical documentation improvement or coding
- Familiarity with DRG payor issues and clinical documentation requirements
- Strong analytical and communication skills
- Previous experience in a hospital setting with interdisciplinary collaboration
- Knowledge of AHIMA Guidelines for compliant query practice
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