Northwell Health

  • North New Hyde Park, NY, United States
Northwell Health
Northwell Health New Hyde Park, NY, USA
THIS POSITION IS A REMOTE ROLE Job Description Conducts audits of 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...

Northwell Health New Hyde Park, NY, USA
Job Description Performs periodic medical record reviews to ensure physician documentation supports complete and accurate coding. Reconciles medical record documentation, coding, claims and reimbursement data to ensure appropriate billing and reimbursement. Provides feedback to physicians and office staff on findings and makes recommendations to coding management for improvement. Job Responsibility * Collaborates with coding and compliance staff in the performance of periodic physician medical record reviews. * Reconciles medial record documentation, coding, claims, and reimbursement data. * Ensures appropriate billing and reimbursement. * Collaborates with practice revenue managers to ensure correlation of information on superbills with rendered clinical services. * Reviews codes diagnoses and surgical procedures in accordance with established coding and abstracting guidelines as a part of physician medial records review. * Makes recommendations for changes and...

Northwell Health Great Neck, NY, USA
Job Description Performs complex coding audits, drafts findings and advises with organization leadership to provide education on regulations and mitigate compliance risk. Job Responsibility Reviews data, such as claims detail, coding and medical record documentation to determine compliance with appropriate coding and documentation requirements. Drafts reports detailing coding audit findings. Assists with billing/documentation and regulatory risk assessments. Acts as the internal expert on coding issues to ensure compliance with state and federal regulations. Research, interpret and communicate federal and state laws and guidelines pertaining to Medicare and NYS Medicaid. Completes thorough reviews of governmental coding audits determining potential non-compliance and future compliance risk. Provides general compliance education and support to audit and facility staff involved in coding and billing; focused training based on results of compliance audits...

Northwell Health Great Neck, NY, USA
Job Description Conducts coding audits to optimize diagnosis related groupings. Develops and implements coding instruction classes. Prepares coding guidelines; implements coding changes. Job Responsibility Demonstrates comprehensive knowledge of coding guidelines and principals; performs coding audits for optimization. Demonstrates effective skills in validation; provides ad-hoc education to the coding staff. Able to communicate effectively with coders and CDI staff. Demonstrates knowledge of coding policy and procedures. Maintains knowledge of all current Federal and State coding guidelines; remains up-to-date on system literature from all agencies. Monitors and evaluates case mix index; demonstrates comprehensive knowledge of case mix indexing. Reviews potential reassignments; demonstrates accurate and timely review of all reassignments. Implements coding changes; demonstrates ability to relate coding changes accurately and efficiently to staff....

Northwell Health Riverhead, NY, USA
Job Description Performs coding and abstracting duties to assure accurate completion of coding for all assigned patient records. Job Responsibility * * Analyzes and interprets the medical record in its entirety to ensure accurate, complete and consistent selection of diagnoses and procedures to assure the production of quality healthcare data and accurate facility payment. * * Applies understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable codes. * * Utilizes resources and reference materials (e.g., on-line sources, manuals) to identify appropriate codes and reference code applicability, rules and guidelines. * * Applies the Uniform Hospital Discharge Data Set (UHDDS) definitions as well as any additional regulatory guidelines and/ or coding references to select the principal diagnosis, secondary diagnoses, all significant procedures, indicating the patient's acuity, severity of illness and risk of mortality (if applicable), as...

Northwell Health Glen Cove, NY, USA
Job Description Conducts Home Health Resource Group (HHRG) Validation to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record. Job Responsibility 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. Instructs professional staff in code changes, as needed. Assists clinical staff and nursing supervisors in providing appropriate documentation in the Medical Record. Identifies appropriate coding changes necessary to provide the most valid documentation in compliance with Federal and State regulations. Reports to supervisor and visiting nurses those Medical Records that are deficient in diagnosis and clinical documentation. Reviews Outcome Assessment...

Northwell Health Port Jefferson, NY, USA
Job Description FT 37.5 hrs 8a-4p Performs various billing duties. Codes and reports diagnosis, investigates and resolves diagnosis coding issues, and participates in educational activities concerning coding scheme. Assists in the maintenance of client billing records and statistics and the maintenance of cost per test chargebacks; answers questions and resolved billing issues. Job Responsibility 1.Codes and reports diagnoses in accordance with established guidelines; codes requisitions from physician narratives and pathology reports; investigates and resolves diagnosis coding issues; reviews and updates diagnosis codes received from physician offices on patient's records and submits to insurance companies. 2.Acts as a liaison between guidelines and codes; participates in educational activities concerning coding scheme; researches and prepares bills for reimbursement, outpatient, physician offices, and charge backs; establishes associated accounts, outpatient, physician...

Northwell Health Lake Success, NY, USA
Job Description Performs periodic medical record reviews to ensure physician documentation supports complete and accurate coding. Reconciles medical record documentation, coding, claims and reimbursement data to ensure appropriate billing and reimbursement. Provides feedback to physicians and office staff on findings and makes recommendations to coding management for improvement. Job Responsibility Collaborates with coding and compliance staff in the performance of periodic physician medical record reviews. Reconciles medial record documentation, coding, claims, and reimbursement data. Ensures appropriate billing and reimbursement. Collaborates with practice revenue managers to ensure correlation of information on superbills with rendered clinical services. Reviews codes diagnoses and surgical procedures in accordance with established coding and abstracting guidelines as a part of physician medial records review. Makes recommendations for changes and...

Northwell Health New Hyde Park, NY, USA
Job Description Job Description Performs periodic medical record reviews to ensure physician documentation supports complete and accurate coding. Reconciles medical record documentation, coding, claims and reimbursement data to ensure appropriate billing and reimbursement. Provides feedback to physicians and office staff on findings and makes recommendations to coding management for improvement. Job Responsibility Collaborates with coding and compliance staff in the performance of periodic physician medical record reviews. Reconciles medial record documentation, coding, claims, and reimbursement data. Ensures appropriate billing and reimbursement. Collaborates with practice revenue managers to ensure correlation of information on superbills with rendered clinical services. Reviews codes diagnoses and surgical procedures in accordance with established coding and abstracting guidelines as a part of physician medial records review. Makes recommendations for...