Clinical Documentation Registered Nurse II

Description

Summary:

Reviews inpatient/outpatient medical records prior to admission and throughout hospitalization for specific cardiac procedure and device placement documentation and verification as required by various regulatory agencies.

Requirements:

A. Education/Skills

• Graduate of state board accredited school of nursing or equivalent with a BSN preferred.

• Knowledge of coding rules and guidelines and HIPPA

• Basic computer skills in word processing and spreadsheet utilization.

• Analytic skills necessary to clinically assess medical records.

• Excellent interpersonal skills to develop relationships necessary to influence physician documentation process.

• Excellent prioritization and organizational skills.

• Excellent oral and communication skills.

• Able to be a team player with cardiologists/CV surgeons, nursing and other clinical staff.

• Must meet established productivity targets for record review.

• Maintains strict confidentiality at all times.

B. Experience

• Minimum of five years experience in Cath Lab or Critical Care.

• Experience with compliance audits preferred.

C. Licenses, Registrations, or Certifications

• Current RN license in the State of Texas (or active licensure in another state and in the process of seeking a Texas RN license.

• Certification such as CCM or CCRN preferred.

Work Type:

Full Time