Clinical Documentation Improvement Specialist

🕒 August 26

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🏥📝 Medical Writer

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👻 Ghost score 28%

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Northside Hospital

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1970

🏥 Healthcare

👥 B2C

Healthcare • B2C

Northside Hospital is a large regional hospital system in Georgia that provides comprehensive medical and surgical care across multiple campuses and specialties. The organization offers emergency and trauma services, cardiovascular care, cancer treatment, orthopedics, maternity and neonatal care, and advanced diagnostic and interventional procedures. Northside emphasizes patient-centered care, community wellness and education, clinical innovation, and ongoing expansion of facilities and services.

📋 Description

• Improve the overall quality and completeness of clinical documentation in medical records • Facilitate documentation improvement through interaction with physicians and other healthcare team members • Ensure clinical documentation accurately reflects the patient's clinical status and care provided • Serve as an ongoing educational resource for healthcare team members on clinical documentation issues

🎯 Requirements

• Bachelor of Science in Nursing or higher OR Associate of Science in Nursing with Bachelor of Science or higher in a comparable field • Current License in the State of Georgia as a Registered Nurse or Nursing Compact (NLC/eNLC) or Multistate License • 2 years of nursing experience in acute care • Advanced degree such as MBA, MPH preferred • Knowledge of ICD-10-CM coding conventions and clinical auditing processes preferred • Revenue cycle and operations experience preferred • Coding experience preferred • CDIS Certification preferred • Ability to interact with treating physicians, nurses, CDISs, case managers, quality staff, and coders • Excellent oral and written communications skills • Experience in CQI concepts, tools, and techniques • Ability to interact with numerous facilities and departments • Proficiency in Excel and Word

🏖️ Benefits

• 100% remote work • Day shift: 7am–3:30pm • No weekend requirements • No on-call requirements