South Carolina Licensed Clinical Documentation Specialist

Job Summary

To enhance clinical documentation accuracy, the full-time South Carolina Licensed Clinical Documentation Specialist will conduct reviews of inpatient electronic medical records, identify documentation gaps, and collaborate with healthcare providers to ensure proper diagnosis coding and risk adjustment.

Key responsibilities

• Review inpatient electronic medical records to identify and address missing or incomplete diagnoses
• Collaborate with providers to facilitate accurate documentation that reflects appropriate DRG assignment and patient risk factors
• Participate in educational opportunities and meetings to interpret quality metrics and improve clinical documentation practices

Required qualifications

• Bachelor's degree in nursing from an accredited institution
• Licensure as a registered nurse by the South Carolina Board of Nursing or a compact state
• At least five years of clinical nursing experience preferred
• Strong clinical experience and critical thinking skills
• Extensive knowledge of patient care and clinical measurement tools