Clinical documentation improvement specialist vs medical records clerk

The differences between clinical documentation improvement specialists and medical records clerks can be seen in a few details. Each job has different responsibilities and duties. It typically takes 6-12 months to become both a clinical documentation improvement specialist and a medical records clerk. Additionally, a clinical documentation improvement specialist has an average salary of $64,797, which is higher than the $32,491 average annual salary of a medical records clerk.

The top three skills for a clinical documentation improvement specialist include patients, patient care and clinical documentation improvement. The most important skills for a medical records clerk are patients, customer service, and data entry.

Clinical documentation improvement specialist vs medical records clerk overview

	Clinical Documentation Improvement Specialist	Medical Records Clerk
Yearly salary	$64,797	$32,491
Hourly rate	$31.15	$15.62
Growth rate	11%	11%
Number of jobs	66,130	129,998
Job satisfaction	-	5
Most common degree	Bachelor's Degree, 44%	Associate Degree, 29%
Average age	45	45
Years of experience	12	12

What does a clinical documentation improvement specialist do?

Clinical documentation improvement specialists are professionals who are involved in the clinical documentation improvement (CDI) program that incorporates the terminology needed to translate a patient's condition into precise codes. These specialists must investigate complex healthcare reimbursement information to ensure that appropriate documentation is provided for proper patient care. They must collaborate with physicians and medical record coding staff so that they facilitate the clinical documentation improvement process. Clinical documentation improvement specialists must also train members of the patient care team about the documentation guidelines for medical records.

What does a medical records clerk do?

Medical records clerks are employees in hospitals or clinics who manage office records. They are in charge of creating, updating, and filing patient-related medical records and other related documents. They ensure that all documents are correctly filled out and labeled before storing them safely in their respective storage areas. They may also be in charge of digitizing forms for easier access to files and back up purposes. They ensure that medical records are exact and updated. Medical records clerks should be organized and must always be on top of all tasks related to patient or medical records.

Clinical documentation improvement specialist vs medical records clerk salary

Clinical documentation improvement specialists and medical records clerks have different pay scales, as shown below.

	Clinical Documentation Improvement Specialist	Medical Records Clerk
Average salary	$64,797	$32,491
Salary range	Between $47,000 And $87,000	Between $25,000 And $40,000
Highest paying City	Madera, CA	Rochester, NY
Highest paying state	California	Alaska
Best paying company	Nuance Communications	University of California, Berkeley
Best paying industry	Health Care	Health Care

Differences between clinical documentation improvement specialist and medical records clerk education

There are a few differences between a clinical documentation improvement specialist and a medical records clerk in terms of educational background:

	Clinical Documentation Improvement Specialist	Medical Records Clerk
Most common degree	Bachelor's Degree, 44%	Associate Degree, 29%
Most common major	Nursing	Health Care Administration
Most common college	Duke University	University of Pennsylvania

Clinical documentation improvement specialist vs medical records clerk demographics

Here are the differences between clinical documentation improvement specialists' and medical records clerks' demographics:

	Clinical Documentation Improvement Specialist	Medical Records Clerk
Average age	45	45
Gender ratio	Male, 15.2% Female, 84.8%	Male, 13.1% Female, 86.9%
Race ratio	Black or African American, 9.5% Unknown, 4.2% Hispanic or Latino, 15.7% Asian, 8.9% White, 60.4% American Indian and Alaska Native, 1.3%	Black or African American, 9.2% Unknown, 4.2% Hispanic or Latino, 17.3% Asian, 7.8% White, 60.2% American Indian and Alaska Native, 1.3%
LGBT Percentage	9%	9%

Differences between clinical documentation improvement specialist and medical records clerk duties and responsibilities

Clinical documentation improvement specialist example responsibilities.

Create documentation education classes to general surgery residents, increasing the leveling of reporting which lead to increase revenues.
Interact directly with physicians to query for more specific documentation and to provide documentation guidelines from ICD-9 and ICD-10 standards.
Prepare, maintain and update clinical documentation ensuring completeness and accuracy of services provide to the patients.
Assign the correct POA status.
Participate in the initiation of the CDIS program.
Train new employees on how to utilize radiology information systems.

Medical records clerk example responsibilities.

Manage transition from in-house transcription system to outsource transcription service.
Manage front office check-in, insurance verification and certifications from doctors.
Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
Perform infant labs and update the system with results, triage incoming patients, perform necessary resuscitation to baby and mom.
Provide information to medical facilities and patients when necessary and respond to subpoenas and other general release of patient information.
Experience in CPT and ICD-10 coding.

Clinical documentation improvement specialist vs medical records clerk skills

Common clinical documentation improvement specialist skills

Patients, 18%
Patient Care, 13%
Clinical Documentation Improvement, 12%
CCDS, 8%
ICD-10, 7%
CCS, 6%

Common medical records clerk skills

Patients, 27%
Customer Service, 9%
Data Entry, 7%
Medical Terminology, 6%
HIPAA, 5%
Patient Care, 4%

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Clinical Documentation Improvement Specialist
Clinical Documentation Improvement Specialist vs Medical Records Clerk

Updated January 8, 2025

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