The Clinical Documentation Specialist is responsible for facilitation improvement in the overall quality and completeness of the medical record documentation. Obtains appropriate documentation through extensive interaction with physicians, nursing staff, other patient caregivers and health information management coding staff to ensure that reimbursement if received for the level of services rendered to the patients and that the clinical information utilized in profiling and reporting outcomes is complete and accurate.
Licensed Registered Nurse, current licensure for the State of Louisiana, BSN preferred. Standard vocational preparation - skilled, 4-10 years. Familiarity with Clinical Documentation Process, coding guidelines, TJC, Federal, and State standards and regulations
Minimum 5 years experience in the acute care setting, recent experience in the supervision and treatment of adult patients, prior experience in utilization review, discharge planning, quality management or case management preferred. Knowledge of computer software and hardware application and basic knowledge of statistics.
Skill and proficiency in applying highly technical principles, concepts and techniques that is central to the nursing profession, ability to be objective in stressful situations, advanced communication and interpersonal skills with all levels of internal and external customers. This includes, but is not limited to, medical staff, patients and families, clinical personnel, support and technical staff, outside agencies, and members of the community. Maintain a high degree of confidentiality and adapts easily to ever changing environment
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.