Clinical Documentation Specialist RN

4 weeks ago


Virginia Beach, Virginia, United States Sentara Healthcare Full time
Job Title: Clinical Documentation Improvement Specialist RN

We are seeking a highly skilled and knowledgeable Registered Nurse to join our team as a Clinical Documentation Improvement Specialist RN. This role is responsible for reviewing and improving the accuracy and completeness of clinical documentation in patient medical records.

Key Responsibilities:
  • Conduct concurrent reviews of provider in-patient medical record documentation to ensure accuracy and completeness.
  • Facilitate modifications to clinical documentation through interaction with providers and other healthcare team members.
  • Communicate with providers to ensure timely and accurate documentation.
  • Utilize specific software to code documentation using ICD-10 codes.
  • Provide education and training to medical staff as needed.
Requirements:
  • Minimum of 5 years RN experience in Acute Care, Medical/Surgical, or ICU.
  • BSN required; RN Diploma or Associate's degree accepted with commitment to obtain BSN within 5 years.
  • Active RN license in North Carolina or Virginia.
Benefits:
  • Competitive salary and benefits package.
  • Opportunities for professional growth and development.
  • Collaborative and supportive work environment.
About Sentara Healthcare:

Sentara Healthcare is a leading healthcare system in Virginia and North Carolina, committed to improving health every day. We value diversity, inclusion, and belonging, and strive to create a workplace that reflects the communities we serve.



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