AdressThe future is our choice
At Atos, as the global leader in secure and decarbonized digital, our purpose is to help design the future of the information space. Together we bring the diversity of our people’s skills and backgrounds to make the right choices with our clients, for our company and for our own futures.
Type: 100% Remote
Shift Requirement: Standard Business Hours with some flexibility
Clinical Documentation Specialist
Job Description
Under limited direction and according to Clinical Documentation guidelines and established policies/procedures, responsible for improving the overall quality and completeness of Clinical Documentation in the legal medical record.
• Facilitates necessary documentation in the medical record through extensive interaction with physicians, HIM and coding staff to ensure the most appropriate reimbursement and and highest level of SOI/ROM is achieved for the level of service rendered to all patients
• Educates physicians regarding Clinical Documentation needs, changes to Clinical Documentation guidelines and coding and reimbursement opportunities on an on-going basis
• Applies knowledge of medical terminology and procedures to evaluate clinical documents for documentation and reimbursement opportunities
• Acute Care (inpatient) medical record monitoring (concurrent) of diagnoses, treatments, and follow-up entries in medical records to validate the accuracy of patient medical record documentation and diagnoses – obtaining missing information via a query when necessary
Clinical Documentation Specialist Qualifications
• Must have at least one of the following:
o License to practice as a Registered Nurse preferred (any state)
o Credentialed as a RHIA (Registered Health Information Administrator), RHIT (Registered Health Information Technician) or CCS (Certified Coding Specialist)
• Must have all of the following:
o 1-year Acute Care (inpatient) Concurrent Clinical Documentation Specialist experience
o CCDS (Certified Clinical Documentation Specialist - ACDIS) or CDIP (Certified Documentation Practitioner - AHIMA) credential required
