Registered Nurse Coding Auditor

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

Job Description

Validates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record.

Job Responsibility

• Leverages clinical expertise to identify and validate DRG code assignment.
• Full review of CDI suggested code changes
• Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization.
• Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations.
• Applies coding rules and regulations 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 appropriate coding changes necessary to provide the most valid documentation in compliance with Federal and State regulations.
• Operates under general guidance and work assignments are varied and require interpretation and independent decisions on course of action.
• Reviews potential reassignments; demonstrates accurate and timely review of all reassignments.
• Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.

Job Qualification

• 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, plus specialized certifications as needed.

Preferred Qualification:

• Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) highly preferred
• Epic experience a plus

*Additional Salary Detail
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).