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Clinical Documentation Improvement Specialist
Shriners Hospitals for Children – Portland

Location: Portland, Oregon
Work Setting: Hospital
Job Function:
CDI Specialist, HIM Specialist
Job Type:


Title: CDI Specialist
Department: Health Information Management
Location: Portland, OR
Hours: Full-Time
Schedule: 40 hours a week

Job Description

Job Summary:
Shriners Hospitals for Children-Portland is seeking a full-time CDI Specialist to join our team! This position will facilitate and obtain appropriate physician documentation for any clinical conditions or procedures to support the appropriate severity of illness, expected risk of mortality, and complexity of care of the patient, and to support ICD-10 codes. Exhibits a sufficient knowledge of clinical documentation requirements that identify clinical conditions or procedures to support ICD-10 coding. Educates members of the patient care team regarding documentation guidelines, including attending physicians, allied health practitioners, nursing and care management.

Job Responsibilities:
• Completes initial reviews of patient records to evaluate documentation to assign the diagnosis, procedures for accurate coding assignment, risk of mortality, and severity of illness
• Queries physicians regarding missing, unclear or conflicting health record documentation
• Educates key healthcare providers regarding clinical documentation improvement
• Collaborates with Care managers, Utilization Review Specialists, HIM management, HIM coding management, nursing staff, and other ancillary staff regarding interaction with physicians on documentation and to resolve physician queries prior to patient discharge
• Analyzes trends in data for specified patient populations to identify opportunities for improvement
• Prepares and presents clinical documentation reports for review by leadership
• Educates members of the patient care team regarding specific documentation needs and reporting and reimbursement issues identified through daily and retrospective documentation reviews and aggregate data analysis
• Improve medical clinical documentation to substantiate medical necessity of services and facilitate accurate coding to support ICD-10 coding and billing requirements
• Work collaboratively with hospital departments, other allied health staff and outside governmental and contractual agencies
• Identify opportunities in inpatient clinical medical documentation to support quality, regulatory compliance, and effective coding

Required Qualifications

Qualifications, Skills & Abilities:
• Associates in Nursing or in Health Information Management is required
• Bachelor’s degree in Nursing or HIM is preferred
• 5 years of clinical healthcare experience in an acute care hospital is preferred
• Registered Health Information Administrator (RHIA) is preferred
• Working knowledge of Microsoft applications
• Excellent written, verbal and presentation skills required
• Excellent business judgement and decision-making
• Experience working collaboratively with IT, HIMS and Clinical Operations is preferred


Company Overview:
Shriners Hospitals for Children is committed to providing the highest quality care to children with neuromusculoskeletal conditions, burn injuries and other special healthcare needs within a compassionate, family-centered and collaborative care environment.
Our work environment is mission driven, high quality and provides great satisfaction to all professionals through the unique health care setting. We are an equal employment opportunity employer committed to providing challenging and rewarding careers. Shriners Hospitals for Children is a drug-free and smoke-free workplace.
All of our positions, including on-call positions, are benefits eligible. We offer a robust benefits package including medical, dental, vision, flexible spending account, and a 403(b) retirement plan. Employees who are 0.5 FTE or greater are also eligible for 100% company paid group life insurance, supplemental life insurance, 100% company paid short term disability, long term disability, and a generous PTO accrual. We also offer annual Tri-Met passes to employees at no cost. These passes are good for the bus, max, light rail, and tram.

Instructions for Resume Submission

Please apply online or send your resume to Raquel Lemire at

Apply Online:

Posted: February 11, 2019 at 4:14 PM
Post ID: 36130

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