CDS - SJOMO Medical Records
About The Position
At St. Joseph Medical Center, our dedicated team of professionals is committed to our core values of quality, compassion, and community. As a member of Prime Healthcare, St. Joseph Medical Center is actively seeking new members to join its award-winning team! Founded in 1874 by the Sisters of St. Joseph of Carondelet, St. Joseph Medical Center has a long tradition of providing high-quality, compassionate care. Its Catholic heritage and the spirit of our founding Sisters continue today in our mission of caring for the community. The Diocese of Kansas City-St. Joseph is the Catholic Sponsor for St. Joseph Medical Center, under the leadership of his Excellency Bishop James V. Johnston, Jr. St. Joseph Medical Center has received numerous awards for its quality and clinical excellence. We believe that continuous quality of care and performance improvements are the foundation for preserving and enhancing healthcare delivery. For information, visit www.stjosephkc.com. The Clinical Documentation Specialist (CDS) is responsible for conducting clinically based concurrent and retrospective reviews of inpatient medical records. These reviews are to evaluate whether the clinical documentation is reflective of the quality-of-care outcomes and reimbursement compliance for acute care services provided. The CDS works closely with the medical staff to facilitate appropriate clinical documentation of patient care. Other responsibilities include conducting documentation for inpatient admission criteria, initial and extended-stay concurrent reviews on all selected admissions and documenting findings. He/She will perform other duties as assigned or required.
Requirements
- Medical Graduate, PA or Nursing Graduate
- Minimum of three (3) year’s clinical experience in an acute care setting
- Knowledge of care delivery documentation systems and related medical record documents
- Knowledge of age-specific needs and the elements of disease processes and related procedures
- Strong broad-based clinical knowledge and understanding of pathology/physiology of disease processes
- Excellent written, and verbal communication skills and critical thinking skills
- Excellent interpersonal skills to build effective partnering relationships with physicians, nurse staff, and hospital management staff.
- Working knowledge of inpatient admission criteria.
- Ability to work independently in a time-oriented environment
- Computer literacy and familiarity with the operation of basic office equipment
- Assertive personality traits to facilitate ongoing physician communication
Nice To Haves
- ECFMG Certificate or RN license
- Prior Case Management Experience
- Working knowledge of the Medicare reimbursement system and coding structures
- Current BCLS (AHA) certificate upon hire and maintain current
- ACLS Certificate
Responsibilities
- conducting clinically based concurrent and retrospective reviews of inpatient medical records
- evaluate whether the clinical documentation is reflective of the quality-of-care outcomes and reimbursement compliance for acute care services provided
- works closely with the medical staff to facilitate appropriate clinical documentation of patient care
- conducting documentation for inpatient admission criteria, initial and extended-stay concurrent reviews on all selected admissions and documenting findings
- perform other duties as assigned or required
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
Number of Employees
501-1,000 employees
