Clinical Documentation Spec III PRN - Remote

Cooper Norcross University Hospital • Camden, NJ

2d • $41 - $70 • Remote

About The Position

This is a remote position responsible for ensuring the overall quality and completeness of medical record documentation for all payor groups and DRG types, including MS, AP, and APR. The role facilitates modifications to clinical documentation through concurrent interaction with physicians, nursing staff, other patient caregivers, and Health Information coding staff to support appropriate reimbursement and capture clinical severity for the level of service rendered to all inpatients. This position also supports timely, accurate, and complete documentation of clinical information used for measuring and reporting physician and hospital outcomes, and educates all members of the patient care team on an ongoing basis as needed. The ideal candidate is a professional team player, able to communicate well with others on all levels, and comfortable with regular electronic contacts via telephone or email correspondence. Flexibility and a working knowledge of all areas of adult, pediatric, and obstetric medicine are essential. The role requires the ability to sit for long periods, manual dexterity, and mobility for extensive use of computer screen, keyboard, and other office equipment, with adequate judgment and understanding of potential consequences.

Requirements

• EPIC EHR
• CDE ONE, Solventum
• 5 years minimum experience as Clinical Documentation Specialist in an acute setting, preferably Level 1 Trauma Center.
• CDI Subject matter expert for ALL PAYORS, all DRG groups (MS-DRG, APR-DRG, AP-DRG Elixhauser, risk variables)
• PSI/HAC/HCC (Risk adjustment coding) knowledge/experience and Vizient Calculator
• Excellent critical thinking skills, able to assess, evaluate and teach.
• Self-governed, disciplined, and organized.
• Excellent work ethics, analytical thinking, problem solving.
• Excellent computer skills.
• Excellent verbal and written communication with knowledge of email etiquette.
• Proficient in Word, Excel, PowerPoint.
• Typing (60 WPM).

Nice To Haves

• International Medical Graduate (IMG) from an accredited medical school preferred.

Responsibilities

• Ensuring the overall quality and completeness of medical record documentation for all payor groups, all DRG’s, including MS, AP, and APR.
• Facilitating modifications to clinical documentation through concurrent interaction with physicians, nursing staff, other patient caregivers and Health Information coding staff to support that appropriate reimbursement and clinical severity is captured for the level of service rendered to all inpatients.
• Supporting timely, accurate and complete documentation of clinical information used for measuring and reporting physician and hospital outcomes.
• Educating all members of the patient care team on an ongoing basis, as needed.
• Maintaining professional team player attitude, able to communicate well with others on all levels.
• Engaging in regular electronic contacts with other personnel throughout and outside the hospital via telephone or e-mail correspondence.
• Demonstrating flexibility with a working knowledge of all areas of adult pediatric and obstetric medicine.
• Utilizing manual dexterity and mobility for extensive use of computer screen, keyboard, copy and facsimile machines, reader/printer and other office equipment.

Benefits

• Self provide high speed internet access
• Self provide a phone line
• May be required to self-provide additional monitors (minimum of 2 monitors required)

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree