HCA, Hospital Corporation of America DRG Clinical Reviewer - Registered Nurse (RN) in Lees Summit, Missouri
_DRG Clinical Reviewer - Registered Nurse (RN)_ _ _
At Lee’s Summit Medical Center, above all else, we are committed to the care and improvement of human life, every patient, every time. Located at intersection of 350 highway and Todd George Road in Lee’s Summit Missouri, Lee’s Summit Medical Center continues to be recognized for providing top quality care. Through our values of Integrity, Compassion, Always, Respect and Excellence we strive to exceed our patient’s healthcare needs and live the mission of HCA Midwest Health each day.
As our community grows, so does our campus. Current services include Level III trauma care, Level II Stroke state designations, Accredited Chest Pain Center, Sarah Cannon Cancer Care, and an orthopedic center for excellence. An OR expansion project is currently underway and future plans for our campus include additional expansion of service lines and in increase in our overall bed capacity. With lots of space to grow, Lee’s Summit Medical Center can continue to meet the needs of the residents they serve for years to come.
_Responsibilities:_ _ _ GENERAL SUMMARY OF DUTIES: The purpose of this position is to create consistency and efficiency in inpatient claims processing and data collection to optimize DRG reimbursement and facilitate data quality in hospital inpatient services.
Responsible for facilitating concurrent documentation of the medical record to achieve accurate inpatient coding and DRG Assignment. Reviews records of inpatients to ensure the accurate selection of the principal diagnosis and procedure and any complicating or preexisting conditions, including present on admission diagnosis. Directly works with physicians and case managers to establish concise physician documentation. Involved in physician awareness and education of documentation guidelines in relation to coding guidelines that support appropriate reimbursement. This specialist serves as a key contact person in dealings with HIM Coders to ensure timely facility billing and reimbursement activities.
Education: BSN preferred
Licensure/Certifications:Must have a current MO RN license upon hire or a current multistate RN license. If only a multistate RN license is provided upon hire, a MO RN license will be required within 90 days of employment.
Experience:A minimum of 3 years of acute care clinical experience. Possess in-depth knowledge of medical and anatomical terminology, reimbursement principles, health record content, sequencing of diagnoses, and the use of coding software. Prefer at least 2 years experience as an Inpatient coder or concurrent coding specialist.
• Knowledge of care delivery documentation systems and related medical record documents • Knowledge of age specific needs and the elements of disease processes and related procedures • Strong broad-based clinical knowledge and understanding of pathology/physiology • Excellent written and verbal communication skills and critical thinking skills • Working knowledge of inpatient admission criteria • Ability to work independently in a time-oriented environment • Computer literacy and familiarity with the operation of basic office equipment • Assertive personality traits to facilitate ongoing physician communication • Working knowledge of Medicare reimbursement system and coding structures preferred • Working knowledge of core measures preferred
Title: DRG Clinical Reviewer - Registered Nurse (RN)
Location: Missouri-Lees Summit-Lee%27s Summit Medical Center
Requisition ID: 09724-46435