Clinical Documentation Specialist Job Description Sample Template
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This free Clinical Documentation Specialist job description sample template can help you attract an innovative and experienced Clinical Documentation Specialist to your company. We make the hiring process one step easier by giving you a template to simply post to our site. Make sure to add requirements, benefits, and perks specific to the role and your company.
Clinical Documentation Specialist Job Summary
Our hospital is looking for an experienced and detail-oriented Clinical Documentation Specialist to help us improve the quality of our recordkeeping processes. You will collaborate with the clinical documentation supervisor and medical coding staff to review patient medical records for accuracy and ensure documentation complies with all relevant governmental regulations. Meticulous evaluation of these records helps our physicians, nurses, and other health care staff provide the best care possible to our patients. Applicants must have a current nursing license and at least three years of experience in the medical field.
Clinical Documentation Specialist Duties and Responsibilities
- Review medical charts for accuracy of coding and documentation
- Collaborate with staff to determine areas in need of closer review
- Train physicians and other medical staff on proper documentation procedures to ensure consistency and accuracy
- Update database
Clinical Documentation Specialist Requirements and Qualifications
- Current LPN or RN license
- Medical coding certification (AAPC, AHIMA, CRC, CCS-P, CCS, CPC)
- At least three years of experience in the medical field
- Knowledge of Medicare coding a plus
- Excellent organization and communication skills
- Attention to detail
- Proficient in Microsoft Office
- Valid driver's license and reliable transportation
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