* Insight Global is actively hiring for a Clinical Documentation Specialist to sit remotely working CST hours (8-4:30 PM). The CDI Specialist will be responsible for improving the overall quality and completeness of clinical documentation in legal medical records for the hospital's inpatients. Day-to-day operations consist of but are not limited to:
o Facilitates necessary documentation in the medical record through extensive interaction with physicians, HIM and coding staff to ensure the most appropriate reimbursement is achieved for the level of service rendered to all patients
o Educates physicians regarding clinical documentation needs, changes to clinical documentation guidelines and coding and reimbursement opportunities on an on-going basis
o Applies knowledge of medical terminology and procedures to evaluate clinical documents for documentation and reimbursement opportunities
o 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.
* License to practice as a registered Nurse preferred (any state): required if candidate does NOT possess an RHIA (Registered Health Information Administrator), RHIT (Registered Health Information Technician) or CCS (Certified Coding Specialist) certification (and vice versa).
* Minimum 1 year of experience working as an Acute Care (inpatient) Concurrent Clinical Documentation Specialist
* Minimum 1 year of experience with INPATIENT facility coding
* CCDS (Certified Clinical Documentation Specialist - AHIMA) or CDIP (Certified Documentation Practitioner - ACDIS) credential. If candidate does not already possess and CCDS or CDIP certification, they must be willing to obtain within 1 year of employment. (This is a huge plus and would be preferred if candidates already possess either CCDS or CDIP credentials)
* Experience working with Epic (EMR), 3M360 Encompass (Coding Software) or Idione (CDI Software)
* Experience working for an academic medical center in the capacity of a concurrent clinical documentation reviewer
Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.