CLINICAL DOCUMENTATION SPEC-RN

3 months ago
Requisition ID
2017-5991
# of Openings
1
Department
CLINICAL DOCUMENTATION IMPRVMT
Baptist Hospital
Pensacola
Category (Portal Searching)
Nursing
Position Type
Full-Time
Schedule
Day Shift
Schedule Details
8a-5p

Overview

The Clinical Documentation Specialist- RN facilitates accurate documentation for severity of illness and quality in the medical record. This involves extensive record review, interaction with physicians, health information management professionals, and nursing staff.  Active participation in team meetings and education of staff in the clinical documentation improvement process is a key role.

 

The person in this position works under general supervision, is responsible for various shifts, may be subject to over 40 hours per week and/or callback as required, and may also be required to remain on campus immediately before, during, and after severe weather and/or disasters.

Qualifications

  • Associate of Nursing Degree is required
  • Five years of adult acute care experience in Med/Surg, Critical Care, Emergency Room, or PACU
  • Current state Registered Nurse License
  • Ability to learn/develop the skills necessary to perform clinical documentation improvement
  • Organizational, analytical, writing and interpersonal skills
  • Dependable, self- directed and pleasant
  • Critical thinking, problem solving and deductive reasoning skills
  • Knowledge of Pathophysiology and Disease Process
  • Basic Computer skills – familiarity with Windows based software programs
  • Knowledge of regulatory environment
  • Understand and support clinical documentation improvement strategies (upon completion of training)

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