Clinical Documentation Specialist

Job Description

Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers. Perform concurrent and retrospective reviews of medical records to ensure accurate documentation of patient care. Educate healthcare providers on the importance of accurate and complete clinical documentation. Utilize clinical knowledge and expertise to identify opportunities for documentation improvement. Ensure compliance with regulatory requirements and guidelines. Participate in multidisciplinary team meetings to discuss documentation improvement strategies. Provide feedback to healthcare providers on documentation practices and areas for improvement. Maintain up-to-date knowledge of clinical documentation standards and best practices.

Responsibilities

• Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers.
• Perform concurrent and retrospective reviews of medical records to ensure accurate documentation of patient care.
• Educate healthcare providers on the importance of accurate and complete clinical documentation.
• Utilize clinical knowledge and expertise to identify opportunities for documentation improvement.
• Ensure compliance with regulatory requirements and guidelines.
• Participate in multidisciplinary team meetings to discuss documentation improvement strategies.
• Provide feedback to healthcare providers on documentation practices and areas for improvement.
• Maintain up-to-date knowledge of clinical documentation standards and best practices.

Essential Skills

• Registered Nurse (RN) with a valid Connecticut nursing license.
• Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Practitioner (CDIP) certification.
• Certified Coding Specialist (CCS) certification.
• Minimum of 3 years of clinical nursing experience.
• Strong knowledge of clinical documentation standards and regulatory requirements.
• Excellent communication and interpersonal skills.
• Ability to work collaboratively with healthcare providers and multidisciplinary teams.
• Proficiency in electronic health record (EHR) systems.

Additional Skills & Qualifications

• RN license
• Document control
• Data entry
• Medical
• Clinical documentation
• 3 years of clinical nursing experience
• Excellent communication skills
• Strong analytical and problem-solving skills
• EHR, EMR, Epic

Work Environment

This position is primarily on-site in Middletown, Connecticut. The role may involve occasional travel to other facilities for meetings and training sessions. The schedule is Monday-Friday 9am-5pm.

Pay and Benefits

The pay range for this position is $40.00 - $48.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully onsite position in Middletown,CT.

Application Deadline

This position is anticipated to close on Apr 10, 2025.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

• Hiring diverse talent
• Maintaining an inclusive environment through persistent self-reflection
• Building a culture of care, engagement, and recognition with clear outcomes
• Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

Salary : $40 - $48