Registered Nurse Coding Auditor

Northwell Health; Village of Lake Success (NY); Sur place; USD 90 000 - 110 000; Plein temps

Résumé du poste

Northwell Health in New York seeks a skilled Registered Nurse to validate acute inpatient coded charts, ensuring documentation substantiates the diagnostic information and DRG assignments.

The role emphasizes auditing CDI-coded changes, applying coding guidelines, and communicating DRG rationale to the coding team; RN licensure in NY and nursing degree required, CCS/CIC preferred.

Qualifications

• RN with NY licensure and nursing degree.
• Experience in clinical coding and DRG validation.
• Familiarity with coding guidelines and audits.

Responsabilités

• Validate DRG code assignments using clinical documentation.
• Conduct full reviews of CDI suggested code changes.
• Audit Medicare and non-Medicare charts for regulatory compliance.
• Communicate DRG changes and rationale to the CDI staff.
• Apply coding rules to the validation process.
• Review potential reassignments and document decisions.

Connaissances

Nursing

Clinical coding

Auditing

Regulatory compliance

Communication

Formation

Bachelor’s Degree in Nursing

New York RN License

CCS or CIC certification (preferred)

Outils

Epic experience

Description du poste

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).