Documentation Clerk is responsible for clerical duties related to the maintenance of technical documentation. Completes tracking, logging, updating and version control of technical documents according to business standards. Being a Documentation Clerk requires a high school diploma or equivalent. Typically reports to a supervisor. The Documentation Clerk works under the close direction of senior personnel in the functional area. Possesses a moderate understanding of general aspects of the job. May require 0-1 year of general work experience. (Copyright 2024 Salary.com)
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Under the direct supervision of the Regional Manager, the Clinical Documentation Quality Liaison is responsible for promoting high-quality clinical documentation by collaborating with the CDI, HIM, Quality Departments as well as with the Medical and Surgical Service Lines across the central and south regions of Hackensack Meridian Health (HMH). Promotes improvement initiatives directed at system-wide quality indicators (i.e. Mortality, Patient Safety Indicators [PSI], Hospital Acquired Conditions, Severe Maternal Morbidity, etc.) and clinical evidence to support DRG, principal diagnosis, and secondary diagnoses assignments. Other duties this position may be asked to undertake include, but are not limited to, performing second level CDMP chart reviews for accuracy and compliance when there is a discrepancy in the Clinical Documentation Specialist and Coder DRG and coaching of the CDMP Team on PSI, review and screen inpatient admissions and observations as specified by the facility's Utilization Management/Review Committee for documentation completeness and compliance with patient status, and communicates the transfer of appropriate concurrent information to the inpatient Case Managers and the Clinical Documentation Specialists (CDS) assigned to the unit.
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