Posted Jul 11, 2026

Clinical Documentation Specialist, Second Reviewer

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MO-REMOTE

Worker Type:

Regular

Job Summary:

Performs as a vital member of the interdisciplinary care team member, an auditor, and an educator ensuring medical records are complete and clinical documentation comprehensively represents the current health status of network patients against ever-changing risk adjusted models. Responsible for achieving improved documentation results and risk adjusted scores for the organization, along with documentation and electronic health record charts that accurately capture the clinical picture.

Job Responsibilities and Requirements:

PRIMARY RESPONSIBILITIES

  • Reviews clinical records of both clinical documentation integrity and mortality scoring.
  • Collaborates with others regardingclinical documentation improvement (CDI) and risk adjustment (mortality) findings.
  • Maintains knowledge of Centers for Medicare and Medicaid Services (CMS) requirements related to clinical documentation and provides feedback to clinical staff regarding these requirements during the concurrent record review process.
  • Maintains knowledge of mortality models, observed rate/expected rate (O/E ratios), industry trends, variable and diagnosis review group (DRG) frequency.
  • Serves as a liaison between coding staff and physicians as appropriate. Identifies and initiates opportunities for new program development or program extensions, as well as opportunities based on outcomes analysis for program process improvements.
  • Works with other team membersregarding opportunities for improvement in standard work.
  • Maintainsdocumentation, logsadjusted risk and CDI opportunities.
  • Applies the existing body of evidence-based practice and scientific knowledge in health care to nursing practice, ensuring that nursing care is delivered based on patient’s age-specific needs and clinical needs as described in the department's scope of service.
  • Works in a constant state of alertness and safe manner.
  • Performs other duties as assigned.

EDUCATION

EXPERIENCE

PHYSICAL REQUIREMENTS

REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS

State of Work Location: Illinois

State of Work Location: Missouri

State of Work Location: Oklahoma

State of Work Location: Wisconsin

Work Shift:

Day Shift (United States of America)

Job Type:

Employee

Department:

8746010033 Sys Clinical Documentation Improvement

Scheduled Weekly Hours:

40

Benefits:

SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs.

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SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity,pregnancy, veteran status, or any other characteristic protected by applicable law.

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