Registered Nurse Coding Auditor

Northwell Health; Village of Lake Success (NY); Vor Ort; USD 90.000 - 120.000; Vollzeit

Zusammenfassung

Northwell is seeking a Nurse CDI/Code Reviewer to validate acute inpatient charts and ensure that diagnostic information substantiates DRG assignments in the medical record.

The role requires RN licensure in New York, a nursing degree, and strong knowledge of coding guidelines. Epic experience is a plus and auditors review Medicare/non-Medicare charts for compliance with federal and state rules.

Qualifikationen

• Graduate from an accredited School of Nursing and licensure, as required.
• Bachelor's Degree in Nursing is required.
• Current RN license in New York State is required; specialty certifications as needed may apply.

Aufgaben

• Leverages clinical expertise to identify and validate DRG code assignment.
• Full review of CDI suggested code changes.
• Demonstrates knowledge of coding guidelines and principles; performs coding audits for optimization.
• Audits and reviews Medicare/non-Medicare charts to ensure 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 to ensure valid documentation per regulations.
• Operates under general guidance; independent decisions on actions.

Kenntnisse

Clinical coding expertise

DRG coding knowledge

Coding guidelines knowledge

Ausbildung

Graduate from an accredited School of Nursing

Bachelor's Degree in Nursing

Current Registered Nurse license in New York State

Tools

Epic

Jobbeschreibung

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).