RN - Clinical Documentation Specialist - Oncology (Remote)

University of Washington Medical Center • Seattle, WA

3d • $126,000 - $172,272 • Remote

About The Position

UW Medical Center-Montlake is hiring a Registered Nurse Clinical Documentation Specialist for Oncology. This remote position reviews clinical documentation, evaluates its completeness and quality, and works with physicians, practitioners, and coding staff to facilitate necessary documentation updates. The specialist supports accurate documentation of patient conditions and treatments to ensure appropriate reimbursement under a DRG-based Medicare methodology, and verifies clinical information used to measure and report patient-care, physician-practice, and medical-center outcomes. The role also provides ongoing education to members of the patient-care team about clinical documentation.

The position has programmatic responsibility for auditing and investigating medical records and reporting on institutional practices and procedures. It collaborates with providers and coding specialists to clarify information, improve supporting documentation, and ensure appropriate DRG assignment. The specialist educates providers on documentation compliance, coding, reimbursement, and performance improvement; leads or participates in Oncology quality-assurance studies; assists with special projects; and serves on or leads committees and task forces as appropriate.

This is a regular, full-time position at 100% FTE, scheduled Monday through Friday on first shift. The listed annual pay range is $126,000 to $172,272. The position requires a Washington State RN license, a bachelor's degree in nursing, at least six years of inpatient oncology nursing experience, and two years of CDI experience. CCDS and/or CDIP certification is desired.

Requirements

• Current licensure to practice as a Registered Nurse in Washington State.
• Bachelor's degree in nursing.
• At least 6 years of inpatient oncology nursing experience.
• 2 years of CDI experience.
• Effective communication skills.
• Strong critical-thinking and problem-solving skills.

Nice To Haves

• CCDS and/or CDIP certification.

Responsibilities

• Perform initial and follow-up audits and investigations of medical records.
• Examine, analyze, and report on institutional practices and procedures for compliance with internal and external regulations and policies, operational efficiency, and accuracy of reports and records.
• Confer with physicians, coding specialists, and others to clarify information, obtain needed documentation, present opportunities, and educate about appropriate DRG assignment based on severity of illness.
• Ensure appropriate DRG assignment and completeness of supporting documentation.
• Educate providers about compliance in medical and clinical documentation, coding and reimbursement issues, and performance-improvement methodologies.
• Lead or participate in Oncology quality-assurance studies as assigned and assist with special projects.
• Serve as a member of or lead committees and task forces as appropriate.
• Review clinical documentation, assess its completeness and quality, and facilitate modifications through communication with physicians, practitioners, and coding staff.
• Verify the accuracy and completeness of clinical information used to measure and report patient-care, physician-practice, and medical-center outcomes.
• Educate members of the patient-care team about clinical documentation on an ongoing basis.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level