RN Clinical Documentation Integrity Specialist - WFH Flexible Join to apply for the RN Clinical Documentation Integrity Specialist - WFH Flexible role at Southwest Healthcare
About Us
Creating Health and Harmony, Southwest Healthcare is a comprehensive network of care with convenient hospital and ambulatory care/outpatient locations here to serve the Southern California community. With over 7,000 passionate providers and healthcare employees, our shared goal is to provide convenient access to a wide range of healthcare services in a way that benefits you, your family, and the entire community.
Job Summary Southwest Healthcare is seeking a Full-Time RN Clinical Documentation Integrity Specialist for our Corona Regional Medical Center location. This position offers a Hybrid/work from home option and provides clinically based concurrent and retrospective review of inpatient medical records to evaluate the utilization and documentation of acute care services.
Responsibilities Provide clinically based concurrent and retrospective review of inpatient medical records to evaluate the utilization and documentation of acute care services. Improve the overall quality and completeness of clinical documentation.
Promote a partnership between concurrent clinical reviews, medical record coders, and physicians to improve documentation and reimbursement.
Facilitate clarification and specificity to clinical documentation through interaction with physicians, advocating for appropriate reimbursement.
Review medical records to identify payer population as documented upon admission and throughout the hospitalization.
Analyze patient status, current treatment plan, past medical history, and identified possible gaps in physician documentation.
Support the accuracy and completeness of clinical information used for measuring and reporting physician and hospital outcomes to reflect severity of illness, intensity of care, and risk of mortality.
May work a hybrid schedule; 3 days onsite required.
Experience / Training / Qualifications Associate's degree in nursing from an accredited college or university required.
Bachelor's degree in nursing preferred.
Minimum of five (5) years recent clinical experience in acute care (Critical Care, Medical/Surgical or Emergency Medicine) required; Critical Care or Medical/Surgical preferred.
Minimum of three (2) years recent experience performing CDI reviews in an inpatient acute care setting required. Three+ years strongly preferred.
Certifications / Licenses Current license as a Registered Nurse in the State of California required.
Current certification(s) for Certified Clinical Documentation Specialist (CCDS) or Certified Clinical Improvement Practitioner (CDIP) required.
Additional licensure/certification such as CCDS-O, CCS, RHIT preferred.
Other Skills and Abilities Knowledge of Joint Commission and Title 22 standards and guidelines.
Compliance with healthcare policies and procedures.
Working knowledge of ICD-10-CM coding guidelines and Medicare reimbursement system.
Ability to set priorities, organize workload, and meet deadlines.
Familiarity with basic medical laws and ethics, including consent and confidentiality.
Knowledge of emergency procedures, medical terminology and abbreviations; ability to relate to clinical personnel, medical staff, and the public.
Proficiency with word processing, databases, and spreadsheets.
Ability to perform under pressure and meet tight schedules.
Benefits Challenging and rewarding work environment.
Competitive compensation and generous paid time off.
Medical, dental, vision and prescription drug plans.
401(k) with company match and discounted stock plan.
Student loan refinancing program and reimbursement for tuition, CEU, certification, and licenses.
Career development opportunities within UHS and its subsidiaries.
Southwest Healthcare is owned and operated by subsidiaries of Universal Health Services, Inc. (UHS). UHS is a Fortune 500 company with a broad network of facilities across the United States.
EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect and equal employment opportunities to all applicants and teammates. UHS subsidiaries are equal opportunity employers and do not discriminate based on race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status, or any other characteristic protected by law.
Avoid and Report Recruitment Scams Be aware of scams where imposters pose as recruiters. Our recruiters will not request financial or personal information by email. Use legitimate UHS career websites to verify opportunities.
Seniority level Not Applicable
Employment type Full-time
Job function Health Care Provider
Industries: Hospitals and Health Care
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