3 Clinical Documentation Specialist Jobs in Salinas, CA
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Salinas Valley Health is Hiring a Clinical Documentation Specialist Near Salinas, CA
Works under the direction of the Director for Health Information Management/Privacy Officer. Provides clinical, technical and analytical evaluation of physician documentation and other data as necessary in order to ensure that the medical record reflects the patient’s severity of illness. Monitors, analyzes and trends the hospital’s case mix index to determine where opportunity for improvement in documentation exists and provides education to the physicians in areas identified.
- Concurrently reviews inpatient medical records to identify documentation opportunities.
- Reviews all clinical documentation to assure all pertinent conditions are documented to reflect the patient’s severity of illness and acuity of care.
- Code current diagnoses and procedures for preliminary DRG.
- Communicates documentation issues to physicians on a daily basis to resolve issues immediately.
- Educates physicians regarding the guidelines for the timeliness, completeness and appropriateness of clinical documentation.
- Educates physicians on the importance of complete and accurate clinical documentation as it relates to patient acuity, severity of illness, physician profiling, core measures.
- Identifies educational opportunities for physicians and develops educational programs to address those areas identified.
- Assesses and analyzes improvement in the quality of clinical documentation for areas of responsibility.
- Monitors, tracks and trends results of interactions and responses to physician queries.
- Collects data showing activities performed and improvements made.
- Identifies process improvement opportunities related to clinical documentation.
- Prepares administrative and clinical statistical reports on a monthly basis.
- Adheres to all federal, state and SVMH policies relating to medical records:
- Assures adherence to Medicare regulations regarding medical record documentation;
- Assures adherence to state and Quality Improvement Organizations (QIO) regulations regarding medical record documentation;
- Assures adherence to Medical Staff Bylaws and Rules and Regulations regarding medical record documentation.
- Adheres to all Salinas Valley Health policies, procedures and employee guidelines:
- Adheres to all Salinas Valley Health policies regarding confidentiality of protected health information;
- Adheres to Salinas Valley Health Code of Ethics
- Adheres to all Medical Record Department policies and Departmental Guidelines.
- Performs other duties as assigned.
Education: Bachelor’s Degree in Nursing (BSN) or a minimum of 5 years of CCS credentialing work experience required.
Licensure: Current California Registered Nurse (RN) license or current CCS credential required. CDIP or CDDS
certification required. New hires/transfer have three and a half (3.5) years from date of hire to obtain CDIP or
CCDS certification and must continually remain current.
Experience: A minimum of five (5) years’ experience in Inpatient Coding or direct patient care nursing required. Three (3) years CDI experience preferred.
Schedule: Full Time, Days, 8am-4:30pm
Job Summary
Full Time
$52k-71k (estimate)
03/23/2023
05/31/2023
The job skills required for Clinical Documentation Specialist include Health Information Management, Clinical Documentation, Confidentiality, etc. Having related job skills and expertise will give you an advantage when applying to be a Clinical Documentation Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Clinical Documentation Specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Clinical Documentation Specialist positions, which can be used as a reference in future career path planning. As a Clinical Documentation Specialist, it can be promoted into senior positions as a Tumor Registrar that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Clinical Documentation Specialist. You can explore the career advancement for a Clinical Documentation Specialist below and select your interested title to get hiring information.
If you are interested in becoming a Clinical Documentation Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Clinical Documentation Specialist for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Clinical Documentation Specialist job description and responsibilities
Finally, a good clinical documentation specialist must be able to maintain patient confidentiality.
02/19/2022: Sioux City, IA
Clinical Documentation Specialist analyzing medical information to assist healthcare providers.
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A clinical documentation specialist, also called a medical coder or billing specialist, oversees all types of health care documents.
02/05/2022: Waco, TX
At the same time, clinical documentation excellence programs should advance the quality, accuracy, and completeness of clinical documentation.
04/02/2022: Atlantic City, NJ
Clinical Documentation Specialist that are structured to be effective and efficient can provide the solutions needed to achieve accurate clinical documentation that contributes to precise health care data that’s required for value-based payment methodolo
02/20/2022: Carson City, NV
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Clinical Documentation Specialist jobs
Ensuring that there us proper documentation where needed
04/10/2022: Asheville, NC
Always strive for point-of-service documentation.
02/21/2022: Altoona, PA
Clinical documentation specialists gather and process these documents.
03/07/2022: Ventura, CA
Documentation specialists work with hospitals and alongside healthcare providers.
01/22/2022: Burlington, VT
Set up documentation shortcuts.
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Step 3: View the best colleges and universities for Clinical Documentation Specialist.
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