RN Coding Auditor: Validate DRG Codes & CDI Reviews

Northwell; Village of Lake Success (NY); On-site; USD 90,000 - 120,000; Full time

Job summary

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.

Qualifications

• 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.

Responsibilities

• 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.

Skills

Clinical coding expertise

DRG coding knowledge

Coding guidelines knowledge

Education

Graduate from an accredited School of Nursing

Bachelor's Degree in Nursing

Current Registered Nurse license in New York State

Tools

Epic

Job description

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.