Nurse Auditor

2 weeks ago

Westbury NY, United States Northwell Health Full time

Seeking RN - BSN or MSN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical.
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 Information Set (OASIS) and visit documentation for errors and inconsistencies related to clinical documentation, including wounds.
* Discusses findings related to OASIS reviews and advises supervisors and suggests needed corrections; instructs in coding rules and conventions that are disseminated to the staff.
* Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.
Job Qualification
* Graduate from an accredited School of Nursing. Bachelor's Degree in Nursing, preferred. Must be enrolled in an accredited BSN program within two (2) years and obtain a BSN Degree within five (5) years of job entry date.
* Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed.

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