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Clinical documentation improvement specialist

Melbourne
beBeeDocumentation
Documentation
Posted: 26 November
Offer description

Clinical Documentation Improvement Specialist Role Overview

This is a stimulating opportunity for an experienced coder to take on the role of Clinical Documentation Improvement Specialist at a reputable healthcare institution.

The position is part-time, 3 days a week with the option to add casual days if desired. We are seeking someone who can collaborate within a supportive and experienced team in developing and delivering education aligned with EMR enhancements and best-practice documentation standards.


Key Responsibilities

* Review medical records to identify documentation gaps and ensure accurate capture of clinical complexity.
* Deliver targeted education to medical, nursing, and allied health staff through ward rounds, workshops, and presentations.
* Educate clinicians on the impact of accurate documentation on DRG assignment.
* Analyse documentation and coding data to identify trends and improvement opportunities.
* Contribute to CDI performance reporting, quality assurance, and KPI monitoring.
* Assist in implementing and optimising digital tools that support clinical documentation processes.
* Support the development of a hospital-wide CDI program through clinician engagement and collaboration.
* Build and maintain strong stakeholder relationships to ensure effective program delivery.
* Stay informed on emerging documentation technologies and contribute to continuous improvement initiatives.

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