Texas Licensed Clinical Documentation Specialist

Job Summary

To enhance the quality of physician documentation, the full-time Texas Licensed Clinical Documentation Specialist will conduct concurrent reviews of inpatient medical records, interact with healthcare teams, and facilitate modifications to ensure comprehensive and accurate coding in a remote setting.

Key responsibilities

• Communicates with physicians and healthcare team members to ensure comprehensive medical record documentation
• Utilizes the clinical documentation system to identify opportunities for improvement in physician and hospital outcomes
• Develops and provides education to internal customers on compliance, coding, and clinical documentation issues

Required qualifications

• Bachelor of Science in Nursing (BSN) or Master of Science in Nursing (MSN) required
• Current State of Texas nursing license or temporary/compact license
• Minimum of five years of recent RN bedside experience in an acute hospital setting; ICU experience preferred
• Experience in clinical documentation or critical care nursing preferred
• Proficiency in computer usage, including database and spreadsheet analysis