Clinical Documentation Specialist: Elevate Patient Care

1103 Team Member Services; Daytona Beach (FL); On-site; USD 44,000 - 82,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Paid Time Off from Day One

403-B Retirement Plan

4 Weeks Paid Parental Leave

Career Development

Whole Person Well-being Resources

Mental Health Resources and Support

Pet Benefits

Job summary

AdventHealth in Daytona Beach is seeking a Clinical Documentation Specialist to review and improve documentation for accuracy and compliance. The role focuses on severity of illness, risk of mortality, and data integrity, with timely chart reviews and data entry into our software systems.

You will collaborate with clinical teams to clarify and refine documentation processes. Ideal candidates bring nursing education, CDI know-how, and strong critical-thinking skills to support the patient care

Qualifications

• Excellent interpersonal and verbal/written communication skills.
• Organize and present information clearly; proficient with multiple software.
• Learn and perform Clinical Documentation Specialist duties.
• Dependable, self-motivated and pleasant.
• Strong critical-thinking, problem-solving and deductive-reasoning skills.
• Knowledge of pathophysiology, disease processes and treatments.
• Ability to prioritize and manage multiple tasks.
• Knowledge of clinical documentation requirements.
• Coding background preferred.
• Knowledge of quality guidelines preferred.

Responsibilities

• Review concurrent medical records for SOI, ROM, and quality.
• Complete accurate and timely record reviews for documentation integrity.
• Input data into software to yield precise metrics via reconciliation.
• Identify opportunities for documentation improvements with clinical teams.
• Initiate CDI severity worksheets and clarifications for inpatients.

Skills

Interpersonal skills

Communication

Computer skills

Critical thinking

Problem solving

Deductive reasoning

Organization

Prioritization

Pathophysiology knowledge

Clinical documentation requirements

Coding background

Education

Bachelor’s in Nursing

Master’s in Nursing

Field of Study: Health Admin/Public Health

Job description

AdventHealth in Daytona Beach is seeking a Clinical Documentation Specialist to review and improve documentation for accuracy and compliance. The role focuses on severity of illness, risk of mortality, and data integrity, with timely chart reviews and data entry into our software systems.

You will collaborate with clinical teams to clarify and refine documentation processes. Ideal candidates bring nursing education, CDI know-how, and strong critical-thinking skills to support the patient care