Clinical Documentation Specialist (RN)

Details

• Department: Case Management
• Schedule: Full Time, Days
• Hospital: Wisconsin Hospitals (statewide)
• Location: 100% REMOTE
  
  

MUST have RN License

Benefits

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

Ways to give back to your community

Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance and salary range at the time of the offer.

Responsibilities

Facilitate improvement in overall quality, completeness and accuracy of medical record documentation.

• Complete admission reviews and assigns a working Diagnosis Related Group. Ensure the working DRG and other information are entered in the Clinical Documentation Improvement database.
• 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.
  
  

Requirements

Licensure / Certification / Registration:

• One or more of the following required:
• Licensed Registered Nurse credentialed from the Wisconsin Board of Nursing or current home state license for multi-state license recognition "Compact State" obtained prior to hire date or job transfer date.
• Registered Reg Health Info Admnstr credentialed from the American Health Information Management Association (AHIMA) obtained prior to hire date or job transfer date.
• Registered Reg Health Info Tech credentialed from the American Health Information Management Association (AHIMA) obtained prior to hire date or job transfer date.
• Certified Coding Specialist (CCS) credentialed from the American Health Information Management Association (AHIMA) preferred.
  

Education

• Bachelor's Degree in Nursing and/or an Associate's Degree in Nursing with a minimum of 10 years of acute care experience in a moderately to highly complex healthcare organization. Experience must include at least 2 years of general medical/surgical experience in addition to other specialty areas such as Surgery, Emergency Department, and Specialized Units (Oncology/Orthopedics/etc.); or Bachelor's of Science in Health Information Management with either RHIA or RHIT certification required with a minimum of 5 years of direct medical coding experience in a moderately to highly complex healthcare organization; CCS certification preferred; or Bachelor's Degree in a clinically related field with 10 years acute care experience in a moderately to Highly complex healthcare organization. Preference will be given to applicants within the following disciplines: Laboratory, Radiology, Respiratory Therapy, and Physical Therapy.
  
  

Work Experience

• Minimum ten (10) years of experience directly applicable to the primary work required.
  
  

Why Join Our Team

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.

Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.

Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.

Equal Employment Opportunity Employer

Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws.

For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster.

As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.

Pay Non-Discrimination Notice

Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.

This Ministry does not participate in E-Verify and therefore cannot employ STEM OPT candidates.