Clinical Documentation Specialist HIM Full Time Days

Since 1917, Emanuel Medical Center has been the heart of healthcare in Turlock, California, providing incredible high-quality care with compassion to the patients we serve. Emanuel Medical Center is more than a medical facility, we are a community resource that tries to help people live better, healthier lives.

The Clinical Documentation Specialist (CDS) is reponsible for facilitating the improvement in the overall quality and completeness of provider-based clinical documentation in the medical record. This position will be responsible for assisting treating providers to ensure that documentation in the medical record accurately reflects the severity of the illness of the patient as well as the level of services rendered. The CDS assesses clinical documentation through extensive review of the medical record, interaction with physicians, nursing staff, other patient care givers, and Health Information Management (HIM) coding staff to ensure that appropirate reimbursement is received for the level of services rendered to patients and the clinical information utilized in profiling and reporting outcomes is complete and accurate. The CDS performs other duties as required.

Graduate from an accredited school of Nursing. Bachelor�s degree in Nursing preferred. Three years of clinically well-rounded medical or surgical acute care nursing experience. Critical care nursing experience preferred. OR Credentialed as a RHIA (Registered Health Information Administrator) or CCS (Certified Coding Specialist). Three years of inpatient coding experience. Clinical Documentation Specialist experience in an acute care hospital preferred. OR Graduate from an accredited medical school, either foreign or domestic, with a CCDS (Certified Clinical Documentation Specialist) or A Certified Documentation Improvement Practitioner (CDIP) and minimum of one year experience working as a Clinical Documentation Specialist in an acute care hospital.

Knowledge of ICD10 coding, as well as strong computer skills preferred.

Experienced CDS with a minimum of 1 year recent experience in CDS role.

Experience with Meditech, 3M, and/or Cerner preferred.

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Employment practices will not be influenced or affected by an applicant�s or employee�s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.