Clinical Documentation Spec(Rn)- Full Time Days

Advocate Aurora Health; Oak Lawn (IL); Hybrid; USD 75,000 - 110,000; Full time

Job summary

Advocate Health in Illinois seeks a Clinical Documentation Specialist to bridge physicians and the care team, ensuring accurate documentation of clinical severity and mortality risk. The hybrid role combines hospital-based work with remote collaboration and education across teams.

The position requires a BSN with 5+ years in inpatient acute care, preference for clinical documentation improvement experience, and Illinois nursing licensure. Strong communication and analytical skills are essential.

Qualifications

• BSN with a minimum of 5 years of inpatient acute care experience (CCU/ICU/ED).
• Clinical documentation improvement experience preferred.
• Current nursing license in the State of Illinois.
• Strong prioritization, communication, problem-solving and critical-thinking skills.
• Proficiency with basic computer skills.
• Knowledge of ICD-10 coding.

Responsibilities

• Facilitate modifications of clinical documentation through interaction with physicians and care team.
• Support timely, accurate, and complete documentation for severity and risk of mortality.
• Educate internal customers on clinical documentation guidelines.
• Improve overall quality and completeness of clinical documentation via chart reviews.
• Adapt to a changing environment and manage multiple requests.
• Work in hospital and from home as needed.

Skills

Inpatient Acute Care

Critical Care

ICU Experience

ED Experience

Prioritization

Communication Skills

Problem Solving

Critical Thinking

Interpersonal Communication

Basic Computer Skills

Education

BSN

Tools

ICD-10 Coding

Job description

CLINICAL DOCUMENTATON SPECIALIST

THIS POSITION IS HYBRID, 2 DAYS REMOTE AND 3 DAYS ON SITE

SHIFT:FULL TIME DAYS

This position works both in the hospital and work from home

Position Requirements:

Graduate from an accredited school of nursing BSN minimum 5 years relevant inpatient acute care experience, Critical Care, ICU, ED experience.

Clinical documentation improvement experience preferred.

Ability to prioritize work Excellent communication skills.

Good problem solving skills Critical thinking skills

Basic Computer skills

Effective problem~solver with good interpersonal communication skills verbal and written

Effective observation analytical and critical thinking skills

Current nursing license in the State of Illinois

Certification in clinical documentation improvement preferred.

Ability to work in changing environment

Ability to prioritize independently and respond to multiple simultaneous requests

Ability to work under stressful conditions and in difficult situations

May be exposed to hazardous materials and life threatening diseases

This position needs to recognize needs and behaviors of specific age groups of patients treated.

Extensive knowledge and experience of ICD~10 coding classification system and DRGs none

Purpose:

This role will facilitate the modifications of clinical documentation through extensive initial and concurrent interaction with physicians and other members of the healthcare team to support appropriate documentation of the clinical severity and risk of mortality is captured for the level of services rendered to select inpatients populations. This role will supports timely accurate and complete documentation of clinical information used for measuring and reporting physician and hospital outcomes and provides education to all members of the health care team on an ongoing basis

Accountabilities:

Improves the overall quality and completeness of clinical documentation by performing chart reviews using clinical documentation guidelines based on accepted standards evidenced based practice and current regulatory requirements.

Educates all internal customers on clinical documentation opp