Clinical Documentation Specialist

 Posted an hour ago
     
 $79511.52 - $110K per year
  
2-5 years experience
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AI Summary

The role focuses on optimizing clinical documentation to improve medical record accuracy and data quality. Key duties include managing DRG inputs and collaborating with providers to ensure the severity of illness is precisely captured.

We Are Hiring

Location: Remote

Facility: Seton Family of Hospitals

Department/Specialty: Clinic Integrity Documentation

Schedule: Full time | Monday - Friday | 8:00 am - 4:00 pm CST

Salary: $79,511.52 - $110,834.59

What You Will Do

  • Optimize Clinical Documentation: Drive measurable improvements in medical record completeness, accuracy, and overall data quality.
  • Manage DRG & Database Inputs: Conduct timely admission reviews to assign and log accurate working Diagnosis Related Groups (DRGs).
  • Cultivate Provider Collaboration: Partner extensively with physicians and mid-level providers to resolve documentation queries prior to patient discharge.
  • Capture Care Severity: Ensure medical records precisely reflect the true severity of illness and the full level of healthcare services delivered.

What You Will Need

Licensure / Certification / Registration:

  • One or more of the following required :
    • Certified Coding Specialist (CCS) credentialed from the American Health Information Management Association (AHIMA) obtained prior to hire date or job transfer date.
    • Certified Professional Coder (CPC) credentialed from the American Academy of Professional Coders (AAPC) obtained prior to hire date or job transfer date.
    • Clinical Documentation Prof. credentialed from the Association of Clinical Documentation Improvement Specialists obtained prior to hire date or job transfer date.
    • Clinical Documentation Prof. credentialed from the American Health Information Management Association (AHIMA) obtained prior to hire date or job transfer date.
    • Registered Nurse credentialed from the Texas Board of Nursing obtained prior to hire date or job transfer date.
    • Reg Health Info Admnstr credentialed from the American Health Information Management Association (AHIMA) obtained prior to hire date or job transfer date.
    • Reg Health Info Tech credentialed from the American Health Information Management Association (AHIMA) obtained prior to hire date or job transfer date.

Education:

  • High School diploma equivalency with 2 years of cumulative experience OR Associate's degree/Bachelor's degree OR 4 years of applicable cumulative job specific experience required.

Additional Preferences

  • CDI experience strongly preferred
  • Second Level Review experience preferred
  • Certified Clinical Documentation Specialist (CCDS) preferred

Why Join Our Team

Ascension is a leading nonprofit Catholic health system with a culture and associate experience grounded in service, growth, care and connection. We empower our 97,000+ associates to bring their skills and expertise every day to reimagining healthcare, together. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you’ll find an inclusive and supportive environment where your contributions truly matter.

Equal Employment Opportunity Employer

Equal employment opportunity employer

Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws. For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster.

Fraud prevention notice

Prospective applicants should be vigilant against fraudulent job offers and interview requests. Scammers may use sophisticated tactics to impersonate Ascension employees. To ensure your safety, please remember: Ascension will never ask for payment or to provide banking or financial information as part of the job application or hiring process. Our legitimate email communications will always come from an @ascension.org email address; do not trust other domains, and an official offer will only be extended to candidates who have completed a job application through our authorized applicant tracking system.

E-Verify statement

Employer does not participate in E-Verify and therefore cannot employ STEM OPT candidates.

Benefits

Paid time off (PTO)Various health insurance options & wellness plansRetirement benefits including employer match plansLong-term & short-term disabilityEmployee assistance programs (EAP)Parental leave & adoption assistanceTuition reimbursementWays to give back to your community

 

Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance, location and salary range at the time of the offer.

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