KPC GLOBAL MEDICAL CENTERS INC.
Anaheim, CA, USA
Job Description ON-SITE POSITION The Clinical Documentation Specialist (CDS)/Coder III is responsible conducting clinically based concurrent and retrospective reviews of inpatient medical records. This review is to evaluate that the clinical documentation is reflective of quality of care outcomes and reimbursement compliance for acute care services provided. The CDS will work closely with the medical staff to facilitate appropriate clinical documentation of patient care. The CDS/Coder III abstracts and codes the diagnostic and procedural information for Inpatient Services and Surgery medical records utilizing the current version of International Classifications of Diseases in accordance with regulatory agencies and hospital specific guidelines. The CDS/Coder III enters the coded data and other abstracted data from the medical record into the electronic information system. This position assumes primary responsibility for clarifying ambiguous documentation, DRG optimization with the...
