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Clinical Documentation Improvement Specialist

Company: VirtualVocations
Location: Vista
Posted on: May 7, 2025

Job Description:

A company is looking for a Clinical Documentation Improvement Specialist (FT- 1.0 FTE, Remote).
Key Responsibilities

Conduct concurrent reviews of inpatient medical records to enhance documentation quality and accuracy
Collaborate with healthcare professionals to ensure documentation reflects the severity of illness and level of services provided
Maintain compliance with coding practices and regulations while providing education and support to clinicians and coders

Required Qualifications

Bachelor's degree in Nursing (RN) or completion of an accredited medical program
Current licensure as a Registered Nurse (RN) or equivalent medical qualification
At least one professional coding or documentation certification (e.g., CCS, CCDS, CDIP, RHIA, RHIT)
Experience in Medical/Surgical or Critical Care nursing is preferred
Familiarity with Epic and 3M 360 Encoder systems is advantageous

Keywords: VirtualVocations, Yucaipa , Clinical Documentation Improvement Specialist, Healthcare , Vista, California

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