Clinical Documentation Specialist
About this role
Where You’ll Work
CommonSpirit Mountain Region’s Corporate Service Center is headquartered in Centennial, CO where our corporate leaders and centralized teams support our hospitals, clinics and people – including marketing, human resources, employee benefits, finance, billing, talent acquisition/development, payor relations, IT, project management, community benefit and more. Many of our centralized teams offer a remote work option which supports a healthy work-life balance while still providing a culture of collaboration and community where incredible people are doing incredible things every day.
Job Summary and Responsibilities
As a Clinical Documentation Integrity (CDI) Specialist, you will work under indirect supervision, facilitate and obtain appropriate physician documentation for any clinical conditions or procedures to support the appropriate severity of illness, expected risk of mortality, and complexity of care of the patient. In this role you will be you will:
- Educate members of the patient care team regarding documentation guidelines and regulatory requirements, including attending physicians, allied health practitioners, nursing, and case management.
- Support timely, accurate, and complete documentation of clinical information used for measuring and reporting hospital and physician-based outcomes
- Work independently majority of the time with a high degree of autonomy.
Job Requirements
In addition to bringing humankindness to the workplace each day, qualified Clinical Documentation candidates will need the following:
Education Requirements
- Nursing Diploma or Associates Degree Required
- BSN preferred
License/Certification Requirements
- Current RN license in state of employment or valid RN license from compact state, required
- CCDS, preferred
- CDIP, preferred
Experience Requirements
- Three years of nursing experience in the inpatient hospital setting (critical care and/or strong med/surg experience preferred) or two years of nursing experience in the inpatient hospital setting and one year of CDI experience
- Must demonstrate Clinical competency through successfully passing Clinical Competency exam through Nuance
- Must demonstrate CDI software competency through passing Clintegrity exam within six months of starting role
- Proficiency with MS Office software
- Proficient in use of Electronic Health Record
- Experience in health information management or hospital quality program preferred
- Self-motivated with excellent interpersonal, critical thinking, analytical, organizational, and writing skills
Physical Requirements
- Sedentary work -(prolonged periods of sitting and exert up to 10lbs force occasionally)
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