Clinical Documentation Specialist RN
About The Position
The Clinical Documentation Specialist (CDS) is responsible for supporting and facilitating the overall quality of medical record documentation by improving the completeness, accuracy, and reliability of clinical documentation. A key success factor of this process is educating providers through the query process and independently supporting them with education and feedback to accurately reflect the patient's true clinical picture within the medical record. In partnering with the coding team, the CDS will be an expert with ICD-10, NS-DRG and APR-DRG assignment. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Regional Medical Center Everett and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence Regional Medical Center Everett received the Health Grades Distinguished Hospital Award for Clinical Excellence four years in a row.
Requirements
- Associate's Degree in Associate of Science in Nursing
- Registered Nurse License (Upon hire)
- 5 years of experience as an RN in acute care setting within the last 5 years OR 2-3 years Clinical Documentation Integrity experience in acute care setting.
Nice To Haves
- Bachelor's Degree in Bachelor of Science in Nursing or a Bachelor of Science degree in healthcare or other related field.
- 5 years of Hospital experience in ICU, ED or Medical/Surgical
- 1 year of Understanding of MS-DRG and APR-DRG assignment and fundamentals of establishing a DRG.
- 1 year of ICD-10 experience and/or understanding
Responsibilities
- Support and facilitate the overall quality of medical record documentation by improving the completeness, accuracy, and reliability of clinical documentation.
- Educate providers through the query process.
- Independently support providers with education and feedback to accurately reflect the patient's true clinical picture within the medical record.
- Partner with the coding team and be an expert with ICD-10, NS-DRG and APR-DRG assignment.
Benefits
- Best-in-class benefits uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
Associate degree
