RN Specialist – Clinical Documentation

Baptist Health

Clinical Documentation Specialist- RN facilitating accurate documentation and improving quality in medical records for Baptist Health Care. Requires extensive record review and staff interaction in Pensacola, FL.

Posted 7/1/2026full-timePensacola • Florida • 🇺🇸 United StatesMid-LevelSeniorWebsite

About the role

Key responsibilities & impact

Reviews medical record for completeness and accuracy for severity of illness (SOI) and quality using the clinical documentation improvement strategies.
Performs accurate and timely medical record review.
Recognizes opportunities for documentation improvement.
Initiates clinical documentation improvement severity worksheet for inpatients.
Formulates clinically credible documentation clarifications.
Requests documentation clarifications as appropriate for SOI, core measures, and patient safety.
Follows up timely on all cases and resolution of those cases with clinical documentation clarifications.
Participates in task force meetings.
Communicates with HIM coding staff and resolves discrepancies
Accurately inputs data into electronic clinical documentation improvement tool.
Understands and support clinical documentation improvement strategies.
Maintains current knowledge/certification.

Requirements

What you’ll need

Associates Degree Nursing Required or
Technical Diploma/Certificate Nursing Required
5 years Adult acute care experience in med/surg, critical care, emergency room, or PACU Required
Registered Nurse Licensed State of Florida or eligible compact state Required

Benefits

Comp & perks

🌐 Worldwide ❌ Jobs You've Hidden ⭐️ Saved Jobs ✅ Applied Jobs ✉️ Email Alerts 👤 Account Baptist Health Website LinkedIn All Job Openings 10,000+ employees 🤝 Non-profit 💊 Pharmaceuticals Healthcare
Non-profit
Pharmaceuticals Baptist Health is the region’s largest not-for-profit healthcare organization, encompassing 12 hospitals, over 28,000 employees, and a network of outpatient centers and urgent care facilities across Florida. With a commitment to medical excellence, Baptist Health operates renowned centers in cancer, cardiovascular care, orthopedics, and neuroscience, providing compassionate and quality care to its patients. The organization has been recognized for its commitment to employee satisfaction and has received numerous accolades for its hospital services and healthcare impact in the community. RN Specialist – Clinical Documentation Job not on LinkedIn 🔥 47 minutes ago 🏢🏡 Pensacola – Hybrid ⏰ Full Time 🟡 Mid-level 🟠 Senior 🏥📝 Medical Writer 🦅 H1B Visa Sponsor Apply Now Find Hiring Managers Customize resume + cover letter Report problem ☆ Save ☑️ Mark as applied ❌ Hide 📋 Description
Reviews medical record for completeness and accuracy for severity of illness (SOI) and quality using the clinical documentation improvement strategies.
Performs accurate and timely medical record review.
Recognizes opportunities for documentation improvement.
Initiates clinical documentation improvement severity worksheet for inpatients.
Formulates clinically credible documentation clarifications.
Requests documentation clarifications as appropriate for SOI, core measures, and patient safety.
Follows up timely on all cases and resolution of those cases with clinical documentation clarifications.
Participates in task force meetings.
Communicates with HIM coding staff and resolves discrepancies
Accurately inputs data into electronic clinical documentation improvement tool.
Understands and support clinical documentation improvement strategies.
Maintains current knowledge/certification. 🎯 Requirements
Associates Degree Nursing Required or
Technical Diploma/Certificate Nursing Required
5 years Adult acute care experience in med/surg, critical care, emergency room, or PACU Required
Registered Nurse Licensed State of Florida or eligible compact state Required Apply Now 📊 Check your resume score for this job Improve your chances of getting an interview by checking your resume score before you apply. Check Resume Score 🌐 Worldwide Built by Lior Neu-ner. I'd love to hear your feedback — Get in touch via DM or support@remoterocketship.com Search Search Jobs by country Search jobs by city Search jobs by job title Search entry-level jobs Search junior-level jobs Search senior-level jobs Search jobs by tech stack Search jobs by contract type Search remote internships Search remote part-time jobs Remote jobs Anywhere in the World Companies Hiring Anywhere in the World Companies Hiring Sales People Anywhere in the World Companies Hiring Software Engineers Anywhere in the World Resources Advice Tips for finding remote jobs Interview questions and answers Resume examples Cover letter examples Post a job Affiliates Privacy policy Terms of service Job board SEO course AI Apply Copilot OpenClaw job finder Jobs by Country Remote jobs anywhere in the world (Worldwide remote jobs) Remote jobs United States Remote jobs Australia Remote jobs Brazil Remote jobs Canada Remote jobs France Remote jobs Ireland Remote jobs Germany Remote jobs Netherlands Remote jobs Spain Remote jobs UK Popular Jobs Remote data analyst jobs Remote customer support jobs Remote executive assistant jobs Remote marketing jobs Remote product designer jobs Remote product manager jobs Remote project manager jobs Remote recruiter jobs Remote sales jobs Remote software engineer jobs Jobs by Type Remote full-time jobs Remote part-time jobs Remote contract jobs Remote internship jobs Remote entry-level jobs Remote jobs with no experience required Remote junior jobs (1-3 years of experience) Digital nomad jobs Remote jobs with no degree required Freelance remote jobs Temporary remote jobs Remote jobs hiring now Stay at home mom jobs

ATS Keywords

✓ Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

Medical Record ReviewClinical Documentation ImprovementData InputDocumentation ClarificationSeverity of Illness Assessment

Soft Skills

CommunicationCollaborationProblem-Solving

Certifications

Registered Nurse License - FloridaNursing Degree or Technical Diploma/Certificate