Clinical Documentation Specialist – CDI HIM

🔥 16 minutes ago

🚗 Michigan – Remote

🚗 Michigan – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🏥📝 Medical Writer

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Trinity Health

WebsiteLinkedInAll Job Openings

10,000+ employees

📚 Education

🤝 Non-profit

🌍 Social Impact

Education • Non-profit • Social Impact

Trinity Health is a Christian K-12 educational institution located in Wichita, Kansas, dedicated to providing a Christ-centered education that nurtures spiritual growth and academic excellence. The academy emphasizes the importance of faith in students' lives, integrating spiritual development with rigorous academic programs and a broad array of extracurricular activities, including athletics and fine arts. Trinity Health fosters a supportive community where teachers and families collaborate to help students develop a personal relationship with Jesus Christ and excel in their studies.

📋 Description

• Achieves appropriate clinical documentation to support the medical necessity and level of services rendered to all patients. • Demonstrates understanding of appropriate clinical documentation to ensure accurate reflection of severity of illness, risk of mortality, and level of services provided. • Assists in overall quality, timeliness, and completeness of the health record to ensure appropriate data and provider communication. • Serves as a resource for appropriate clinical documentation. • Communicates with and educates physicians and healthcare team members regarding clinical documentation and monitors provider engagement. • Identifies learning opportunities for healthcare providers. • Conducts concurrent reviews of selected patient health records to address legibility, clarity, completeness, consistency, and precision of clinical documentation. • Formulates compliant clarifications/queries following Trinity Health’s documentation integrity procedures. • Interacts with physicians, nurses, and ancillary staff regarding compliant documentation requirements and educational opportunities. • Accurately codes all relevant, appropriate, and compliant working diagnoses codes.

🎯 Requirements

• Must possess an Associate/Diploma Degree in Nursing, or Health Information Technology (HIT) OR Advanced degree in nursing or medical field such as NP/APN or PA. • Must possess one of the following: Current Registered Nurse License in the State of practice, Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) required, Licensure as a physician assistant (PA) or Nurse Practitioner/Advanced Practice Nurse (NP/APN) or completion of medical school. • Preferred: Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Professional (CDIP) preferred. • Two (2) years’ experience in Critical Care, Medical or Surgical Inpatient Care Nursing, as an RN, physician assistant (PA), nurse practitioner/advanced practice nurse (NP/APN), medical school graduate or as an inpatient coder preferred.

🏖️ Benefits

• Competitive compensation. • Full benefits package including Medical, Dental, Vision, PTO, Life Insurance, Short and Long-term Disability. • Benefits effective Day One! No waiting periods. • Retirement savings plan with employer match. • Opportunity for growth and advancement throughout Trinity Health. • Tuition Reimbursement