Massachusetts Licensed Clinical Document Specialist

Job Summary

Collaborating with healthcare professionals, the full-time Massachusetts Licensed Clinical Document Specialist will ensure accurate medical record documentation and support coding and reimbursement processes in a remote setting.

Key responsibilities:

• Works collaboratively with physicians and staff to ensure complete and accurate medical record documentation
• Reviews inpatient medical records and identifies gaps in documentation throughout hospitalization
• Communicates with attending physicians to validate observations and suggest necessary documentation improvements

Required qualifications:

• Massachusetts licensure as a registered nurse is required
• Experience in direct patient care, case management, or utilization review is required
• Knowledge of clinical documentation practices and ICD-10-CM diagnosis codes is required
• Excellent interpersonal skills for professional interactions with physicians are required
• Ability to effectively use specialized computer systems for data analysis is required