Nurse Coding Auditor: DRG & CDI Compliance Review

Northwell Health; Town of North Hempstead (NY); On-site; USD 90,000 - 120,000; Full time

Job summary

Northwell Health is seeking a Registered Nurse with CDI expertise to validate Acute Inpatient coded charts, ensuring the documentation supports diagnostic information and DRG assignments. The role requires NY licensure and nursing degree, with preferred CCS/CIC credentials and Epic experience.

Responsibilities include reviewing CDI-suggested code changes, auditing Medicare and non-Medicare charts for regulatory compliance, and communicating DRG changes to CDI staff.

Qualifications

• Graduate from an accredited School of Nursing.
• Bachelor’s Degree in Nursing, required, or equivalent combination of education and related experience.
• Current License to practice as a Registered Professional Nurse in New York State required.
• CCS or CIC certification highly preferred.

Responsibilities

• Leverages clinical expertise to identify and validate DRG code assignment.
• Full review of CDI suggested code changes.
• Demonstrates knowledge of coding guidelines and performs coding audits for optimization.
• Audits Medicare/non-Medicare charts for compliance with Federal and State regulations.
• Applies coding rules to the validation review process.
• Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions.
• Communicates DRG changes and rationale to the coding and CDI staff.
• Identifies coding changes to provide valid documentation in compliance with regulations.
• Operates under general guidance with independent decision-making.
• Reviews potential reassignments and performs timely reviews.

Education

Bachelor’s Degree in Nursing

Graduate from an accredited School of Nursing

CCS or CIC certification (preferred)

Tools

Epic experience

Job description

Northwell Health is seeking a Registered Nurse with CDI expertise to validate Acute Inpatient coded charts, ensuring the documentation supports diagnostic information and DRG assignments. The role requires NY licensure and nursing degree, with preferred CCS/CIC credentials and Epic experience.

Responsibilities include reviewing CDI-suggested code changes, auditing Medicare and non-Medicare charts for regulatory compliance, and communicating DRG changes to CDI staff.