Registered Nurse Coding Auditor

Northwell Health Physician Partners; Village of Great Neck (NY); On-site; USD 90,000 - 145,000; Full time

Job summary

Northwell Health Physician Partners is seeking an Inpatient Coding Specialist to validate Acute Inpatient charts and substantiate diagnostic information with the medical record.

The role focuses on identifying DRG code assignments, performing CDI reviews, and auditing Medicare and non-Medicare charts for compliance with Federal and State regulations. Strong knowledge of coding rules and independent decision-making are essential.

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, plus specialized certifications as needed.

Responsibilities

• Identify and validate DRG code assignment.
• Full review of CDI suggested code changes.
• Audit coding practices to ensure compliance with Federal and State regulations.
• Apply coding rules and regulations to the validation review process.
• Communicate DRG changes and rationale to the coding and CDI staff.
• Review potential reassignments and ensure timely, accurate reviews.
• Perform related duties as required.

Education

Bachelor's Degree in Nursing

Graduate from an accredited School of Nursing

RN license in New York State

Job description

Inpatient Coding Specialist

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.
• The salary range for this position is $90000.00-$145000.00/year.