RN Clinical Documentation Specialist - Elevate Coding

NurseRemotely; United States; Remote; USD 85,000 - 110,000; Full time

Job summary

The Clinical Documentation Specialist (CDS) at St. Tammany Health System enhances medical record integrity by engaging with providers to accurately reflect illness severity, ROM, and case complexity.

This role supports risk adjustment strategies and CMS guidelines within a collaborative, multidisciplinary team. The CDS uses clinical knowledge to educate care teams on documentation and coding, focusing on ICD-10-CM accuracy and HCC capture.

Qualifications

• Graduate of an accredited School of Nursing and current Louisiana RN license.
• Five years of clinical experience in acute or ambulatory care.
• Knowledge of ICD-10 coding principles and Risk Adjustment coding.
• Proficiency with Microsoft Office apps, 3M software and Encoder.
• Strong written/verbal communication, critical thinking and organization.

Responsibilities

• Facilitate accuracy of medical record documentation to reflect severity of illness and risk of mortality.
• Collaborate with physicians and APPs to educate on documentation guidelines and coding requirements.
• Perform pre-visit and retrospective reviews to support risk adjustment strategy.
• Ensure CDI activities align with CMS guidelines and DRG implications.

Skills

ICD-10 coding principles

Risk Adjustment Coding

PowerPoint

Excel

Word

3M software

Encoder experience

Communication skills

Critical thinking

Education

Registered Nurse license (Louisiana)

Bachelor of Science in Nursing preferred

Tools

3M software

Encoder

Job description

The Clinical Documentation Specialist (CDS) at St. Tammany Health System enhances medical record integrity by engaging with providers to accurately reflect illness severity, ROM, and case complexity.

This role supports risk adjustment strategies and CMS guidelines within a collaborative, multidisciplinary team. The CDS uses clinical knowledge to educate care teams on documentation and coding, focusing on ICD-10-CM accuracy and HCC capture.