Clinical Documentation Impact Specialist

Emanate Health; West Covina (CA); On-site; USD 80,000 - 120,000; Full time

Job summary

Emanate Health in California seeks a Clinical Documentation Integrity Specialist (CDIS) to improve the quality, completeness, and accuracy of clinical documentation through collaboration with providers and the care team.

The CDIS will query for missing or unclear diagnoses, assign MS-DRG/APR-DRG, SOI, ROM, and identify HACs/PSIs, while upholding AHIMA/ACDIS guidelines and the CDI Code of Ethics.

Qualifications

• Bachelor's degree is required.
• Minimum of one year inpatient coding experience or CDI experience in acute care.
• Strong knowledge of MS-DRG, APR-DRG and ICD-10-CM/PCS coding guidelines.
• Experience using encoder and electronic health record (EHR) systems.
• Excellent verbal and written communication skills.
• Strong analytical thinking, problem-solving abilities, and attention to detail.
• Proficiency in Microsoft Office applications preferred.
• CDIS-related certification CCDS or CDIP within 1 year of hire/transfer.

Responsibilities

• Ensure documentation accurately reflects the patient’s clinical conditions and level of service.
• Interact with providers to address missing or unclear diagnoses via compliant queries.
• Assign MS-DRG/APR-DRG, SOI, ROM and identify relevant clinical indicators (HACs, PSIs).
• Apply AHIMA/ACDIS guidelines and the CDI Code of Ethics in daily practice.

Skills

MS-DRG knowledge

APR-DRG knowledge

ICD-10-CM/PCS coding

Encoder experience

EHR systems

Verbal and written communication

Analytical thinking

Problem-solving

Attention to detail

Education

Bachelor's degree

Tools

Microsoft Office

Job description

Emanate Health in California seeks a Clinical Documentation Integrity Specialist (CDIS) to improve the quality, completeness, and accuracy of clinical documentation through collaboration with providers and the care team.

The CDIS will query for missing or unclear diagnoses, assign MS-DRG/APR-DRG, SOI, ROM, and identify HACs/PSIs, while upholding AHIMA/ACDIS guidelines and the CDI Code of Ethics.