Registered Nurse Coding Auditor
About The Position
Validates acute inpatient coded charts to ensure the diagnostic information supporting code assignments can be substantiated by the medical record. Uses clinical expertise to identify and validate DRG code assignments, reviews CDI-suggested code changes, and audits Medicare and non-Medicare charts for accuracy and compliance with applicable coding standards, rules, and regulations. Communicates DRG changes and their rationale to coding and CDI staff and identifies coding changes needed to support valid documentation in compliance with Federal and State regulations. Work is performed under general guidance; assignments vary and require interpretation and independent decisions. The role also reviews potential reassignments and performs related duties as required. The responsibilities described are considered essential functions under the Americans with Disabilities Act; related duties not listed are not considered essential functions.
Requirements
- Graduate from an accredited School of Nursing.
- Bachelor’s degree in Nursing, or an equivalent combination of education and related experience.
- Current license to practice as a Registered Professional Nurse in New York State.
- Specialized certifications as needed.
- Comprehensive knowledge of coding guidelines and principles.
Nice To Haves
- Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) certification is highly preferred.
- Epic experience is a plus.
Responsibilities
- Validate acute inpatient coded charts against medical-record documentation.
- Use clinical expertise to identify and validate DRG code assignments.
- Fully review CDI-suggested code changes.
- Apply knowledge of coding guidelines and principles and perform coding audits for optimization.
- Audit and review Medicare and non-Medicare charts to ensure standards are maintained in compliance with Federal and State regulations.
- Apply coding rules and regulations to the validation review process.
- Review codes on Medicare and non-Medicare charts for compliance with rules and conventions.
- Communicate DRG changes and the rationale to coding and CDI staff.
- Identify appropriate coding changes needed to provide valid documentation in compliance with Federal and State regulations.
- Review potential reassignments and complete reviews accurately and on time.
- Perform related duties as required.
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What This Job Offers
Job Type
Full-time
