Senior CDI & Clinical Documentation Specialist

LCS Lifespan Corporate Services d/b/a Brown University Health; United States; On-site; USD 94,000 - 188,000; Full time

Job summary

Brown University Health seeks a Senior Clinical Documentation Specialist to audit and improve clinical documentation quality, ensuring accurate severity, risk of mortality, and complexity of care. You will collaborate with physicians, nursing staff, and coding to maximize specificity and educational impact.

You will use advanced CDI methods with tools like EPIC, 3M/360 Life Chart, and query development to educate staff, manage workflow, and support outcomes reporting.

Qualifications

• 3 years of clinical documentation experience in acute care.
• BSN required; master's degree preferred.
• Active RN license in Rhode Island or equivalent licensure.
• ACDIS or AHIMA certification is a plus.
• Experience with ICD-10 and MS-DRG coding and queries.

Responsibilities

• Demonstrates expert knowledge of CDI issues related to ICD-10 and DRG assignment.
• Educates and mentors staff; develops educational materials for providers.
• Performs concurrent and retrospective reviews using risk-adjusted methods.
• Develops and updates CDI query templates and tests platforms (EPIC, 3M/360).
• Manages EPIC work queues and develops complex queries with staff guidance.
• Performs standard CDI reviews meeting productivity, 20–24 reviews/day.

Skills

Clinical documentation

ICD-10 coding

MS-DRG

EPIC

3M/360 Life Chart

Query development

Mentoring

Productivity management

Education

RN with Rhode Island licensure

BSN

Master's degree preferred

Physician assistant or nurse practitioner license

ACDIS/AHIMA certification

Tools

EPIC

3M/360 Life Chart

Job description

Brown University Health seeks a Senior Clinical Documentation Specialist to audit and improve clinical documentation quality, ensuring accurate severity, risk of mortality, and complexity of care. You will collaborate with physicians, nursing staff, and coding to maximize specificity and educational impact.

You will use advanced CDI methods with tools like EPIC, 3M/360 Life Chart, and query development to educate staff, manage workflow, and support outcomes reporting.