State Licensed Clinical Documentation Specialist

Job Summary

A company is looking for a Clinical Documentation Specialist to support the accuracy of clinical documentation in a remote capacity.

Key Responsibilities

• Review and evaluate medical record documentation for completeness, accuracy, and compliance
• Collaborate with healthcare professionals to ensure appropriate clinical documentation
• Identify opportunities for documentation improvement to support coding accuracy and clinical outcomes

Qualifications

• 2 years of clinical documentation improvement (CDI) experience
• Registered Nurse (RN) certification
• Knowledge of ICD-10-CM, MS-DRGs, coding guidelines, and compliance standards
• Experience using 3M and Epic preferred but not required