Clinical Documentation Specialist I - RN-1
Medical University of South Carolina · US
Job Description Summary The RN (Registered Nurse) – Clinical Documentation Specialist I report to their respective Manager, Clinical Documentation.
Job description
Job Description Summary The RN (Registered Nurse) – Clinical Documentation Specialist I report to their respective Manager, Clinical Documentation. Under general supervision, the RN – Clinical Documentation Specialist I conduct reviews of inpatient electronic medical records to identify missing, vague, and/or incomplete diagnoses and collaborate with and facilitate appropriate provider documentation to accurately reflect appropriate DRG (Diagnosis Related Group) assignment, patient severity of illness and risk of mortality. In addition, the CDI (Clinical Documentation Integrity) specialist risk adjusts for expected mortality/length of stay and clinically validates key diagnoses. The RN – Clinical Documentation Specialist I is responsible for a baseline understanding of interpreting quality metrics and participates in appropriate ICCE meetings, QAPIs, and/or other identified educational opportunities across the system. Entity: Medical University Hospital Authority (MUHA) Worker Type: Employee Worker Sub-Type: Regular Cost Center: CC005073 CHS - Clinical Documentation Pay Rate Type: Salary Pay Grade: Health-28 Scheduled Weekly Hours: 40 Work Shift: Job Description: The RN (Registere...