Home Care Coding Specialist-Diagnosis

1 week ago


Garden City, Michigan, United States Northwell Health Full time
Job Title: Home Care Coding Specialist-Diagnosis

We are seeking a highly skilled and experienced Home Care Coding Specialist-Diagnosis to join our team at Northwell Health.

Job Summary:

The Home Care Coding Specialist-Diagnosis will be responsible for validating acute inpatient coded charts to ensure that the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record.

Key Responsibilities:
  • Leverage clinical expertise to identify and validate DRG code assignment.
  • Perform full review of CDI suggested code changes.
  • Demonstrate comprehensive knowledge of coding guidelines and principles; perform coding audits for optimization.
  • Audit and review Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations.
  • Apply coding rules and regulations to the validation review process.
  • Review codes on Medicare/non-Medicare charts for compliance to rules and conventions.
  • Communicate DRG changes and rationale to the coding and CDI staff.
  • Identify appropriate coding changes necessary to provide the most valid documentation in compliance with Federal and State regulations.
  • Operate under general guidance and work assignments are varied and require interpretation and independent decisions on course of action.
  • Review potential reassignments; demonstrate accurate and timely review of all reassignments.
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.



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