Clinical Document Improvement Specialist

US Tech Solutions; San Francisco (CA); Hybrid; USD 150,000 - 200,000; Full time

Job summary

An innovative firm is seeking a Clinical Document Improvement Specialist to enhance the accuracy of clinical documentation in medical records. In this role, you will leverage your clinical expertise to conduct thorough record reviews and collaborate with healthcare professionals to ensure compliance with regulatory standards. This position offers a unique opportunity to impact patient care quality while working in a dynamic environment that balances onsite and remote work. If you are passionate about improving clinical documentation and making a difference in healthcare, this role is perfect for you.

Qualifications

• 2+ years of CDI experience in a complex acute care setting.
• Strong clinical knowledge to ensure accurate documentation.

Responsibilities

• Facilitate complete clinical documentation in medical records.
• Utilize concurrent review processes to optimize documentation quality.

Skills

Clinical Documentation Improvement (CDI)

MS-DRG Classification

Regulatory Compliance

Record Review

Job description

Clinical Document Improvement Specialist

Pay Range: $45.00/hr - $60.00/hr

Shift: 5 x 8 Days, with start times from 07:00 - 08:30, rotating; approximately 50% onsite and 50% remote.

Requirements:

1. At least 2 years of CDI experience in a complex acute care setting.

Job Description:

• The Clinical Documentation Specialist (CDS) uses strong clinical experience and knowledge to facilitate complete and specific clinical documentation in the medical record, reflecting the patient's accurate clinical picture. This involves extensive record review, interaction with physicians, allied health professionals, health information management professionals, and nursing staff.
• The CDS assists the organization by utilizing a concurrent review process to promote optimized severity of illness and quality in the medical record.
• This includes MS-DRG classification according to regulatory compliance set forth by Centers for Medicare and Medicaid Services (CMS).
• This process will be applied to all Medicare Fee for Service (FFS) patients as well as any other payers identified by the organization in a manner consistent with all pertinent coding and compliance regulations.
• Case review prioritization is based on the prioritization by the organization and may also include review of records for accuracy of documentation related to APR-DRG classification and Quality Data elements (e.g. Patient Safety Indicators, Readmissions, etc.).

About US Tech Solutions:

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com.

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Seniority Level:

Mid-Senior level

Employment Type:

Contract

Job Function:

Other

Industries:

Hospitals and Health Care