Impactful RN: Clinical Documentation Specialist

St. Tammany Parish Hospital; Covington, Northern (LA, KY); Hybrid; USD 90,000 - 120,000; Full time

Job summary

St. Tammany Health System seeks a Clinical Documentation Specialist to enhance medical record accuracy and coding quality.

You will engage with physicians and APPs to ensure proper documentation of severity, acuity and complexity, and perform pre-visit and retrospective reviews to support risk adjustment strategies. Requirements include an active Louisiana RN license, 5+ years in acute/ambulatory care, ICD-10 knowledge, and proficiency with 3M, Encoder and MS Office.

Qualifications

• Graduate of an accredited School of Nursing; Louisiana RN license required.
• Five years of clinical experience in acute or ambulatory care.
• Knowledge of ICD-10 coding principles and Risk Adjustment Coding.
• Proficiency with Microsoft Office, 3M software, and Encoder.
• Excellent written and verbal communication, critical thinking, and interpersonal skills.
• Knowledge of complex disease processes in outpatient settings.
• Works independently with minimal supervision and strong organizational skills.
• RN with CCDS certification or BSN preferred.

Responsibilities

• Improve integrity of medical record documentation through provider interaction.
• Support accurate depiction of severity of illness, risk of mortality, and care complexity.
• Perform pre-visit and retrospective reviews for ambulatory documentation.
• Educate physicians and PAs on documentation guidelines, coding requirements, and service-line needs.

Skills

ICD-10 coding principles

Risk Adjustment Coding

Excellent communication

Critical thinking

Interpersonal skills

Independent with minimal supervision

Organizational and planning skills

Education

Louisiana RN License

BSN preferred

Tools

3M software

Encoder

Microsoft Office Suite

Job description

St. Tammany Health System seeks a Clinical Documentation Specialist to enhance medical record accuracy and coding quality.

You will engage with physicians and APPs to ensure proper documentation of severity, acuity and complexity, and perform pre-visit and retrospective reviews to support risk adjustment strategies. Requirements include an active Louisiana RN license, 5+ years in acute/ambulatory care, ICD-10 knowledge, and proficiency with 3M, Encoder and MS Office.