Clinical Documentation Specialist

Facilitate improvement in overall quality, completeness and accuracy of medical record documentation. Complete admission reviews and assigns a working Diagnosis Related Group. Initiate and maintain extensive interactions with physicians and mid-level providers to address the need for more detailed information in the medical record. Collaborate with healthcare professionals to ensure the severity of illness and level of services provided are accurately reflected in the medical record and to resolve physician queries and documentation issues prior to patient's discharge. Maintain accurate records of review activities, ensuring reports and outcomes of CDI efforts are valid.

• Facilitate improvement in overall quality, completeness and accuracy of medical record documentation.
• Complete admission reviews and assigns a working Diagnosis Related Group.
• Initiate and maintain extensive interactions with physicians and mid-level providers to address the need for more detailed information in the medical record.
• Collaborate with healthcare professionals to ensure the severity of illness and level of services provided are accurately reflected in the medical record and to resolve physician queries and documentation issues prior to patient's discharge.
• Maintain accurate records of review activities, ensuring reports and outcomes of CDI efforts are valid.

• Licensure / Certification / Registration: One or more of the following required: Certified Coding Specialist (CCS) credentialed from the American Health Information Management Association (AHIMA) obtained prior to hire date or job transfer date.
• Education: High School diploma equivalency with 2 years of cumulative experience OR Associate's degree/Bachelor's degree OR 4 years of applicable cumulative job specific experience required.

• Paid time off (PTO)
• Various health insurance options & wellness plans
• Retirement benefits including employer match plans
• Long-term & short-term disability
• Employee assistance programs (EAP)
• Parental leave & adoption assistance
• Tuition reimbursement

Ascension Wisconsin has been providing rewarding careers to healthcare professionals since 1848. Operating 17 hospital campuses and over 100 related healthcare facilities from Racine to Appleton, you will find opportunities that allow you to create a career path you love, all while delivering compassionate, personalized care to the communities we serve.