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Clinical Documentation Improvement Specialist
1.
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Personal Information

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Additional Information

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Attachments

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Employment History

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Education History

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Applicant Statements

I declare under penalty of perjury that the facts contained in this application for employment by Valley Presbyterian Hospital are true and complete to the best of my knowledge. I understand that any false information or omission will disqualify me from further consideration for employment and will alone be justification for my dismissal from employment, if discovered at a later date.


I have all the licenses and professional certifications listed in the job announcement, job advertisement, job description as well as those discussed in my interview, or that are necessary to perform the job(s) for which I am applying.


I authorize the investigation of all statements contained in this application (and accompanying resume if any).  I further authorize any person, school, current employer (except as expressly noted), past employer(s), and organizations to give you and/or an outside agency any and all information they may have, personal or otherwise. I release all parties from all liability for any damage that may result from furnishing information and opinion to you.  I understand that Valley Presbyterian Hospital may request a consumer report from a consumer reporting agency with this authorization from me. I also understand that under the Federal Fair Credit Reporting Act I have the right to make a written request to Valley Presbyterian Hospital within a reasonable time, for the disclosure of the name and address of the consumer reporting agency to obtain a complete disclosure of the consumer report.


If an offer of employment is extended and to determine my fitness for the job, I give permission for a complete pre-employment physical examination including a drug screening exam and x rays, and I consent to the release to Valley Presbyterian Hospital of any and all information as may be deemed necessary.


If I become employed, I agree to conform to the rules and regulations of Valley Presbyterian Hospital. I also agree that my employment is AT-WILL and may be terminated at any time, with or without cause or with or without notice at the option of myself or Valley Presbyterian Hospital. AT-WILL employment means  that the Hospital may make decisions regarding other terms and conditions of employment, including but not limited to demotion, promotion, transfer, compensation, benefits, duties, and location of work at any time, with or without cause or advance notice. No manager, supervisor, or employee of the Hospital, other than the Board of Directors, has the authority to modify this policy, either orally or in writing, or to create an agreement for employment, whether express or implied, for any specified period of time or to make any agreement for employment other than AT-WILL.  Any changes must be in writing and signed by the Board of Directors and the employee.

Candidate Sign Off

I certify that all of the information in this application is true and correct as of this date.

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