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System Retrospect Clinical Documentation Specialist I Remote
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Job Description
- Req#: 24003171
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Comprehensive benefits from day one, including mental health resources and support
- Opportunities for career development and growth within the organization
- Work remotely with a flexible schedule, Monday to Friday
- Be part of a community focused on the wholeness of each person and uplift others in body, mind, and spirit
- Commitment to maintaining high standards of integrity and quality in patient care
What to Expect (Job Responsibilities):
- Strategically facilitate and obtain quality physician documentation for clinical conditions and procedures
- Educate the patient care team on documentation guidelines, ensuring compliance with regulatory standards
- Review medical records for documentation accuracy and completeness related to severity of illness and risk of mortality
- Initiate and present opportunities for documentation improvement to healthcare team members
- Communicate effectively with physicians and healthcare providers to ensure accurate clinical documentation
What is Required (Qualifications):
- Associate degree with a minimum of 5 years of experience in acute care
- At least 5 years of acute care nursing experience in medical/surgical, intensive care, post-acute care, or emergency department settings
- Minimum of 3 years of experience as a Clinical Documentation Specialist
- Current active State license as a Registered Nurse, Nurse Practitioner, Physician's Assistant, or equivalent
- CCDS (Certified Clinical Documentation Specialist) or CDIP (Certified Documentation Improvement Practitioner) certification
How to Stand Out (Preferred Qualifications):
- Additional certifications or training in Clinical Documentation Improvement
- Experience with CDI software and data reconciliation processes
- Strong critical-thinking skills and experience in documentation compliance strategies
- Familiarity with Medicare documentation regulations and guidelines
- Proven ability to work collaboratively within a healthcare team
#HealthcareServices #ClinicalDocumentation #RemoteWork #CareerDevelopment #PatientCare
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