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Clinical Documentation Specialist
at Actalent
Posted: 4-18-2025
Remote
Healthcare
$64,200/year
Apply to this job
You’ll be taken to a third party website to find the job application. You got this!
About this Career
Medical Records Specialists
Skills
Electronic Medical Record, Medical Records, Registered Nurse (RN), Certified Documentation Improvement Practitioner (CDIP), Communication, Interpersonal Communications, Nursing, Clinical Nursing, Retrospective Reviews, Epic EMR, Problem Solving, Clinical Documentation, Certified Clinical Documentation Specialist (CCDS), Certified Coding Specialist (CCS)
Job Description
Clinical Documentation Specialist - FULLY REMOTE Job Description Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers. Perform concurrent and retrospective reviews of medical records to ensure accurate documentation of patient care. Educate healthcare providers on the importance of accurate and complete clinical documentation. Utilize clinical knowledge and expertise to identify opportunities for documentation improvement. Ensure compliance with regulatory requirements and guidelines. Participate in multidisciplinary team meetings to discuss documentation improvement strategies. Provide feedback to healthcare providers on documentation practices and areas for improvement. Maintain up-to-date knowledge of clinical documentation standards and best practices. Responsibilities Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers. Perform concurrent and retrospective reviews of medical records to ensure accurate documentation of patient care. Educate healthcare providers on the importance of accurate and complete clinical documentation. Utilize clinical knowledge and expertise to identify opportunities for documentation improvement. Ensure compliance with regulatory requirements and guidelines. Participate in multidisciplinary team meetings to discuss documentation improvement strategies. Provide feedback to healthcare providers on documentation practices and areas for improvement. Maintain up-to-date knowledge of clinical documentation standards and best practices. Essential Skills Registered Nurse (RN) with a current license. Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Practitioner (CDIP) certification. Certified Coding Specialist (CCS) certification if holding CCDS 2; if holding CCDS 1, no additional certification needed. Minimum of 3 years of clinical nursing experience. Strong knowledge of clinical documentation standards and regulatory requirements. Excellent communication and interpersonal skills. Ability to work collaboratively with healthcare providers and multidisciplinary teams. Proficiency in electronic health record (EHR) systems. Additional Skills & Qualifications Excellent communication skills. Strong analytical and problem-solving skills. Experience with EHR, EMR, and Epic systems. Work Environment Fully remote role.
Schedule:
Monday-Friday, 9am-5pm with potential for flexibility as long as a 40-hour work week is maintained.Other Job Posting Details
Salary
Minimum
Maximum
$44,410/yr
$85,530/yr