California Licensed Documentation Specialist

Job Summary

Working remotely in a full-time capacity, the California Licensed Documentation Specialist will review medical records to ensure accuracy and completeness of clinical documentation, assign medical codes, and support regulatory compliance through audits and staff training initiatives.

Key responsibilities:

• Conduct clinical documentation reviews and resolve identified discrepancies in medical records
• Integrate processes to enhance clinical documentation improvement and issue resolution
• Facilitate staff training on clinical documentation standards and regulatory compliance

Required qualifications:

• Minimum two (2) years of experience in an inpatient acute care or clinical setting
• Bachelor's degree in Nursing, Medicine, Health Administration, Health Information Management, or a related field, along with relevant experience
• California Physician Assistant License, Doctor of Medicine License, Nurse Practitioner Certificate, or Registered Nurse License required at hire