Certified Clinical Documentation Specialist

Job Summary

To support clinical documentation integrity, the full-time Certified Clinical Documentation Specialist will perform concurrent reviews of inpatient acute-care medical records remotely, ensuring accurate documentation and collaborating with clinical staff to enhance documentation practices.

Key responsibilities

• Perform concurrent reviews of inpatient acute-care medical records to ensure documentation accuracy
• Complete 15-16 chart reviews daily, applying clinical criteria to assess documented diagnoses
• Collaborate with physicians and clinical teams to improve documentation quality and compliance

Required qualifications

• Minimum 3 years of Clinical Documentation Specialist experience in an inpatient acute-care setting
• Active CCS, CDIP, or CCDS certification at the time of application
• Healthcare-related education preferred, with relevant experience considered in lieu of formal education
• Strong knowledge of clinical criteria, clinical validation, and inpatient coding guidelines
• Experience with Optum CAC is preferred