About The Position

Validates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record.

Requirements

  • 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

  • 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.
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