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Jobs

Clinical Documentation Specialist Outpatient Corewell Health

Clinical Documentation Specialist Outpatient
Southfield, Michigan

Works collaboratively with providers in the ambulatory setting to ensure overall specificity, accuracy and completeness of clinical documentation to support the highest integrity of the medical record. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do.

8 days ago

Clinical Documentation Specialist Nebraska Methodist Hospital

Clinical Documentation Specialist
Council Bluffs, Iowa

1. Performs concurrent review of clinical documentation for all selected admissions to ensure documentation supports and accurately reflects all disease processes being treated or affecting care while the patient is hospitalized by analyzing documentation for incompleteness, identifying ambiguous, conflicting or clinically incongruent documentation and ensure the documentation supports treatment being provided. Works in partnership with physicians, care coordinators, utilization management, staff nurses and Coding Specialists to ensure the medical record accurately reflects patient acuity for quality reporting and case mix index.

15 days ago

Clinical Documentation Specialist (40 hrs/Temple Physicians Inc.) Temple Health

Clinical Documentation Specialist (40 hrs/Temple Physicians Inc.)
Philadelphia, PA

Temple Health consists of Temple University Hospital (TUH), Fox Chase Cancer Center, TUH-Jeanes Campus, TUH-Episcopal Campus, TUH-Northeastern Campus, Temple Physicians, Inc., and Temple Transport Team. Responsible for accurately transposing and reconciling clinical documentation from the EMR into the payer specific systems to provide information for proper risk adjustment of patients and increase revenue to the health plans and internal organization.

30+ days ago

Clinical documentation Specialist Katalyst Healthcares & Life Sciences

Clinical documentation Specialist
North Chicago, IL

Creates and presents reports to study teams, collaborating with functional areas to finalize and archive study Master Files in the electronic Master File system, and supporting audit and inspection preparations to ensure Master File readiness. Provide training and support to new team members, serving as a mentor to guide best practices in document management and conducts QC Checks on document processing of internal and external staff to ensure quality thresholds are being met.

8 days ago

Clinical Documentation Specialist II Mindlance

Clinical Documentation Specialist II
North Chicago, IL

Creates and presents reports to study teams, collaborating with functional areas to finalize and archive study Master Files in the electronic Master File system, and supporting audit and inspection preparations to ensure Master File readiness. Provide training and support to new team members, serving as a mentor to guide best practices in document management and conducts QC Checks on document processing of internal and external staff to ensure quality thresholds are being met.

8 days ago
Houston Methodist logo

Clinical Documentation Specialist Physician – Internal Medicine (Hospitalist Experience Required) Houston Methodist

Clinical Documentation Specialist Physician – Internal Medicine (Hospitalist Experience Required)
Texas

Work Shift : 1 - Day (United States of America) Job Category : Non-clinical With more than 40 locations throughout the Greater Houston area, Houston Methodist Primary Care Group brings quality, compassionate care to the entire family and to the communities where our patients work and live. As part of the Houston Methodist health system — one of the nation’s leading health systems — the Primary Care Group offers efficient access to world-class specialty care and hospital services from a network comprised of the nation’s leading hospitals and health care professionals.

12 days ago

Clinical Documentation Specialist Terrebonne General Health System

Clinical Documentation Specialist

Responsible for ensuring that clinical documentation within the health system accurately reflects the services and care provided to patients and is consistent with the criteria for high-quality clinical documentation, Acts as a coordinator of physician clinical documentation, coding and reimbursement processes in working towards agreed upon quality and productivity targets for all services in the system. Critical care or strong medical/surgical background required or surgical background if assigned to surgical areas; 3-5 years in clinical practice preferred.

30+ days ago

Inpatient Clinical Documentation Specialist Enjoin

Inpatient Clinical Documentation Specialist
Remote
  • Full time

Leveraging strong clinical judgment and CDI expertise, this role reviews concurrent and retrospective patient records, identifies documentation improvement opportunities, and issues compliant provider queries to ensure the patient's severity of illness, risk of mortality, and overall clinical picture are accurately reflected. Working as an extension of our clients' Clinical Documentation Improvement (CDI) programs, the Inpatient CDS helps support accurate coding, appropriate reimbursement, regulatory compliance, and high-quality patient data while delivering exceptional client service.

20 days ago

Clinical Documentation Coordinator Global Force USA

Clinical Documentation Coordinator
Las Vegas, Nevada

Option 3: Certification in one of the following: Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA), issued by the American Health Information Management Association, Certified Professional Coder (CPC), Certified Professional Coder-Physician-based (CPC-P), AND one of the following: Certified Document Improvement Practitioner (CDIP), Certified Clinical Documentation Specialist (CCDS), Certified Clinical Documentation Specialist-Outpatient (CCDS-O). Facilitates modifications to clinical documentation through extensive interactions with physicians, nursing staff, other members of the health care team and Health Information Management (HIM) coding staff to ensure that appropriate reimbursement and clinical severity is captured for the level of service rendered to all patients with a DRG based payer.

28 days ago

Clinical Documentation Coordinator -- Las Vegas, NV Global Force USA

Clinical Documentation Coordinator -- Las Vegas, NV
Las Vegas, Nevada

Option 3: Certification in one of the following: Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA), issued by the American Health Information Management Association, Certified Professional Coder (CPC), Certified Professional Coder-Physician-based (CPC-P), AND one of the following: Certified Document Improvement Practitioner (CDIP), Certified Clinical Documentation Specialist (CCDS), Certified Clinical Documentation Specialist-Outpatient (CCDS-O). Facilitates modifications to clinical documentation through extensive interactions with physicians, nursing staff, other members of the health care team and Health Information Management (HIM) coding staff to ensure that appropriate reimbursement and clinical severity is captured for the level of service rendered to all patients with a DRG based payer.

27 days ago

Clinical Documentation Specialist - Coding Pyramid, Inc

Clinical Documentation Specialist - Coding
Oakland, CA
  • $45–$50 / hour
  • Full time

Key Requirements and Technology Experience: Minimum of four (4) years of clinical nursing experience in inpatient care, clinical documentation, discharge planning, or case management. Collaborate with physicians and medical coding staff to identify and clarify additional diagnoses impacting severity of illness and risk of mortality indicators.

30+ days ago

Clinical Documentation Specialist II- Full Time days Cape Fear Valley Health System

Clinical Documentation Specialist II- Full Time days

Facilitate clarification to clinical documentation in the medical record; through extensive concurrent reviews with interactions with physicians, nursing staff, other interdisciplinary team caregivers and health information management coding staff, which supports appropriate acuity, resource utilization, quality, severity of illness/risk of mortality (SOI/ROM) and reimbursement. Confer with physicians face-to-face, via Epic Secure chat, phone and/or via queries to clarify information in medical record, obtain needed documentation, present opportunities and education regarding the significance of appropriate documentation needed to support the clinical severity of the patient.

13 days ago

Clinical Documentation Specialist II- Full Time Days Cape Fear Valley Health System

Clinical Documentation Specialist II- Full Time Days

Facilitate clarification to clinical documentation in the medical record; through extensive concurrent reviews with interactions with physicians, nursing staff, other interdisciplinary team caregivers and health information management coding staff, which supports appropriate acuity, resource utilization, quality, severity of illness/risk of mortality (SOI/ROM) and reimbursement. Confer with physicians face-to-face, via Epic Secure chat, phone and/or via queries to clarify information in medical record, obtain needed documentation, present opportunities and education regarding the significance of appropriate documentation needed to support the clinical severity of the patient.

30+ days ago

RN Clinical Documentation Specialist - Referrals Ensemble Health Partners

RN Clinical Documentation Specialist - Referrals
Putnam, Connecticut

Educates key healthcare providers such as physicians, nurse practitioners, allied health professionals, nursing and care coordination regarding clinical documentation improvement, documentation guidelines and the need for accurate and complete documentation in the health record. Works collaboratively with co-works and management to effectively resolve root cause issues that impact payor contracts, hospital operations, or departmental to maintain reimbursement and minimize appeal requests and/or denials.

29 days ago

Clinical Documentation Integrity Specialist St. John's Episcopal Hospital

Clinical Documentation Integrity Specialist
Far Rockaway, NY

Additionally, St. John's is proud to be redesignated as a Baby-Friendly Hospital by Baby-Friendly USA - the accrediting body and national authority for the Baby-Friendly Hospital Initiative (BFHI) in the United States. The hospital is a recipient of the Gold-Plus Get with the Guidelines-Stroke Quality Achievement Award and the Gold-Plus Get with the Guidelines-Heart Failure Quality Achievement Award from the American Heart Association.

30+ days ago

Clinical Documentation Integrity Specialist Episcopal Health Services

Clinical Documentation Integrity Specialist
Far Rockaway, New York

Additionally, St. John's is proud to be redesignated as a Baby-Friendly® Hospital by Baby-Friendly USA – the accrediting body and national authority for the Baby-Friendly Hospital Initiative (BFHI) in the United States. The hospital is a recipient of the Gold-Plus Get with the Guidelines®-Stroke Quality Achievement Award and the Gold-Plus Get with the Guidelines®-Heart Failure Quality Achievement Award from the American Heart Association.

30+ days ago

Clinical Documentation Specialist - CDI Mercor

Clinical Documentation Specialist - CDI
New York, New York
Remote
  • $50–$150 / hour

Comfort working inside CAC/CDI software and reading the full clinical record, including H&Ps, consults, progress notes, discharge summaries, labs, and flowsheets. Ensure codes are changed, queries sent, holds placed, DRG recomputed, and notes and CDI reviews filed.

17 days ago

Clinical Documentation Specialist - CDI - AI Trainer Mercor

Clinical Documentation Specialist - CDI - AI Trainer
Nashville, Tennessee
Remote
  • $50–$150 / hour

Comfort working inside CAC/CDI software and reading the full clinical record, including H&Ps, consults, progress notes, discharge summaries, labs, and flowsheets. Ensure codes are changed, queries sent, holds placed, DRG recomputed, and notes and CDI reviews filed.

17 days ago

RN Clinical Document Improvement Specialist NY United Health Services

RN Clinical Document Improvement Specialist
Binghamton, New York

United Health Services (UHS) is a locally owned, not-for-profit healthcare system in New York’s Southern Tier comprising four hospitals, long-term care and home care services, and physician practices in Broome and surrounding counties. UHS provides healthcare and medical services for two-thirds of the region’s population, produces $1.3 billion a year in total economic impact, and boasts a workforce of more than 6,300 employees and providers.

30+ days ago

Clinical Documentation Specialist (40 Hrs/Temple Physicians Inc.) Temple University Health System

Clinical Documentation Specialist (40 Hrs/Temple Physicians Inc.)
Philadelphia, PA

Responsible for accurately transposing and reconciling clinical documentation from the EMR into the payer specific systems to provide information for proper risk adjustment of patients and increase revenue to the health plans and internal organization. The specialist provides valuable feedback to management for provider education and correction purposes, ensuring that patient records are complete and compliant with payer guidelines in a timely matter.

30+ days ago
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