Clinical Documentation Integrity Specialist I

Prisma Health

. Conduct concurrent medical record reviews of selected patient health records .

Posted 10/7/2026full-timeRemote • South Carolina • United StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in clinical documentation improvement, coding accuracy, and healthcare team collaboration. Proficient in ICD-10 Coding, MS-DRG/APR-DRG, and compliant query policies to enhance patient care and documentation quality.

Highest-signal resume keywords

ICD-10 CodingMS-DRG/APR-DRGClinical Documentation ImprovementRHIA/RHIT/CCS/CIC CertificationRN License

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical Record ReviewCoding ReconciliationQuery ProcessDRG AssignmentClinical Documentation Accuracy

Soft Skills

Communication SkillsCollaborationEducation and Follow-Up

Tools & Technologies

Health Information Management SystemsCoding Software

Certifications & Qualifications

RHIARHITCCSCIC

Industry Keywords

IPPSComorbid ConditionsSeverity of IllnessRisk of MortalityLength of StayPrincipal DiagnosisPOA Status

About the role

Key responsibilities & impact

Conduct concurrent medical record reviews of selected patient health records
Address clarity, completeness, consistency, and accuracy of clinical documentation
Use the query process to ensure documentation reflects severity of illness, risk of mortality, comorbid conditions, length of stay, principal diagnosis, and POA status
Complete reconciliation to ensure accurate coding
Develop and maintain collaborative relationships with providers and healthcare team members, including education and follow-up
Stay current with coding guideline changes, treatment modalities, clinical disease indicators, and compliant query policies
Serve as a resource for coworkers, providers, and support departments
Assign a working DRG for healthcare team discharge planning and CDI use
Perform other duties as assigned

Requirements

What you’ll need

Associate degree in Nursing, Health Information Management, or related field of study
Two (2) years of adult medical/surgical/critical care/ER/PACU nursing, coding, or related experience
RHIA, RHIT, CCS, CIC, or licensure in a related field of study
Current RN compact/multistate license recognized by the NCSBN Compact State, or RN license to practice in the state where the team member is working
Computer skills
Communication skills with ability to interact with providers
General knowledge of IPPS, ICD-10 Coding, MS-DRG/APR-DRG, and HCPCS coding systems preferred