Revenue Cycle Audit
Validates 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.
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.
*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).