Clinical Document Specialist

4 weeks ago


Somerville, United States RWJ Barnabas Full time

Responsibilities:

Bridging the gap between the Physician documentation and the Coding professional through compliance review of inpatient charts. Communicate in person, through query documents, via telephone with Physicians to improve or complete documentation necessary for appropriate coding compliance. Provide educational materials and seminars to physicians, coding staff, and other interested areas to improve chart documentation. Maintain a database of documentation completion statistics, including queries, and prepare reports on compliance quarterly to Administration, HIM management staff and Medical Staff senior management. Work with the Coding Quality Officer to ensure the coding staff are educated regarding new documentation requirements, new documents, and assist with clinical questions.

Qualifications:

A combination of 2 - 5 years of recent, acute hospital experience as a clinical nurse in Med/Surg, Critical Care, Emergency Department, Step Down preferred.

Education: Associates in Nursing required, Bachelors in Nursing desired

Required: RN with active New Jersey RN License

RWJBarnabas Health is an Equal Opportunity Employer



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