Job Description
Facilitates and obtains appropriate clinical documentation for all clinical conditions or procedures to support the appropriate severity of illness, expected risk of mortality, and complexity of care provided. Responsible for concurrent inpatient medical record reviews for Medicare, Medicaid and all commercial payers. Generates queries and have follow up discussions with physicians for clarification of ambiguous or conflicting documentation.
Job Responsibility
- Facilitates modifications to clinical documentation supporting appropriate reimbursement is received for the level of service rendered to all patients.
- Demonstrates knowledge of payor issues, documentation opportunities, clinical documentation requirements, and referral policies and procedures.
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Job Qualification
- Graduate from an accredited School of Nursing required. Must obtain a Bachelor of Science in Nursing degree within 5 years of employment date.
- Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed.
- 1-3 years of relevant experience, required.
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).