Job Objective: Facilitates clinical documentation improvement through extensive daily interaction with physicians, caregivers, case management and coding staff to achieve timely, accurate, and complete documentation. In doing so, provides on-going physician/provider education and consultation to improve the accuracy, completeness, specificity and compliance of the in-patient acute care Medical Record. Educates physicians/providers, RNs and other healthcare disciplines in understanding the importance of accurate documentation that reflects EMC’s patient population as it is related to severity of illness and risk of mortality.
Education: BSN or Bachelor’s degree in a related Healthcare field from an accredited college or university (required).
Licensure/Certification: Active California RN license (required). CCS, RHIT, ICD-10 AHIMA training certification or equivalent (preferred).
Experience: A minimum of 5 years recent clinical nursing experience in an acute care setting (required). Knowledge of MS-DRG methodology and inpatient coding rules and regulations (preferred).