Registered Nurse Coding Auditor

FlexStaff; Village of New Hyde Park (NY); On-site; USD 85,000 - 120,000; Full time

Job summary

FlexStaff is seeking a Revenue Cycle Audit professional to validate DRG code assignments for acute inpatient charts. You will leverage clinical nursing expertise to ensure documentation substantiates diagnoses and coding decisions.

You will review CDI suggested changes, apply coding rules, and audit Medicare and non-Medicare charts to maintain compliance with Federal and State regulations. Epic experience is a plus.

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 using clinical expertise.
• Full review of CDI suggested code changes.
• Audit Medicare/non-Medicare charts for 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.
• Identify appropriate coding changes to provide valid documentation in compliance with Federal and State regulations.

Skills

Nursing expertise

DRG coding knowledge

Auditing skills

Education

Bachelor's degree in Nursing

RN license (NY)

Tools

Epic EHR

Job description

Revenue Cycle AuditValidates

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).