Clinical Documentation Specialist

Job Summary

A company is looking for a Clinical Documentation Specialist.

Key Responsibilities

• Provides concurrent review of clinical documentation in medical records
• Queries medical staff to obtain accurate and complete documentation
• Performs thorough chart reviews to identify co-morbidities and complications

Required Qualifications, Training, and Education

• A minimum of a bachelor's degree plus relevant certifications and two years of experience in clinical documentation improvement or inpatient coding, or a bachelor's degree in an allied health field with three years of experience
• Completed coursework in medical terminology and anatomy and physiology
• CCDS and/or CDIP Certification is ideal
• ICD-10-CM/PCS Coding training and certification is highly desired