Senior Clinical Documentation Specialist

Job Summary

A company is looking for a Senior Clinical Documentation Improvement Specialist.

Key Responsibilities

• Conduct reviews of inpatient medical records to identify documentation gaps and communicate needs for additional documentation
• Collaborate with various departments to enhance the quality of provider documentation and support educational initiatives
• Provide data reports and educational support for required documentation elements to inpatient healthcare providers

Required Qualifications

• Education: RN, BSN, RHIA, RHIT, CCS, CPC, CIC, CCDS, or CDIP
• Experience: 3 years of CDI experience and 1 year in nursing, inpatient coding, UM, CM, Quality, or related field
• Proficiency in the Clinical Documentation Specialist role with strong clinical knowledge
• Advanced knowledge of healthcare regulations, documentation requirements, and quality measures
• Ability to produce reports and interpret clinical data effectively