Clinical Documentation Specialist at New York Presbyterian
about 1 year ago
You will need experience in acute care nursing settings, such as in med/surg, cardiac, respiratory and oncology. You also need solid knowledge about infectious disease, lung and cardiac disease. Know the work up involved in septic presentations and underlying causes of presenting symptoms. Your focus in Clinical Documentation will be to educate the providers about documenting the underlying cause of the patient's presentation after work up and any secondary conditions that cause the patient to remain in the hospital. The complexity of the patient's condition and treatment will reflect the length of stay, severity of illness and risk of mortality - the documentation must reflect that.