116 Harvest Lane
Pilot Grove, MO 65276
Job Objective Looking for work within the company in the position of Clinical Documentation Improvement Specialist. Experienced with behind the scenes managerial duties as well as hands-on work in the industry.
Summary of Qualifications:
- Huge experience in conducting medical review and data analysis
- Sound knowledge of cared delivery documentation systems and medical record documents
- Extensive knowledge of disease processes and clinical medicine
- In-depth knowledge of CMS rules and regulations
- Proficient in 3M encoder, acute care abstracting, reporting applications and MS Office suite
- Familiarity with ICD-9, DRG system, HCPCS, MS-DRGS, data analysis and reporting
- Strong clinical assessment and coding skills
- Excellent communication and organizational skills
- Superior time management and analytical skills
Clinical Documentation Improvement Specialist, May 2006 – Present
HCA Healthcare, Pilot Grove, MO
- Prepared, maintained and updated clinical documentation ensuring completeness and accuracy of services provided to the patient.
- Collected and documented data related to patient illness, intensity of services and risk of mortality.
- Ensured proper documentation of discharge diagnoses and co-existing complications to completely reflect the patient’s clinical status and care.
- Developed and implemented plans for both formal and informal education of physician, nursing, and other clinical staff.
- Identified strategies for changing work process to facilitate complete, accurate clinical documentation.
- Ensured adherence to established productivity targets for record review.
Clinical Documentation Improvement Specialist, March 2003 – April 2006
Adirondack Medical Center, Pilot Grove, MO
- Monitored and recorded information on National Hospital Quality Measures (NHQM) inpatients.
- Trained nurses and physicians on NHQM standards.
- Acted as inter-departmental NHQM liaison.
- Coordinated the development, maintained and monitored data quality.
- Analyzed NHQM compliance provided regular progress reports to Core Measure Team.
- Maintained current competence in all aspects of NHQM.
Bachelor’s Degree in Healthcare, William Jewell College, Liberty, MO