Rn Clinical Documentation Denials Auditor

Inova Benefits and Perks:

• Health, Vision, & Dental Coverage
• Life Insurance, Short/Long Term Disability
• NEW! 4 weeks PAID PARENTAL LEAVE
• Retirement: Inova matches dollar for dollar the first 5% of eligible pay that you contribute to the plan
• Competitive Pay: Based on experience 
• Paid Time Off: Begin accruing PTO hours on your first day of work
• Supplemental Plans: Auto/Home Insurance discounts, Pet Insurance, Identity Theft Protection
• Additional Benefits: Educational Assistance of up to $5,250/year, Student Loan Refinancing, Adoption Assistance, Child Care Centers, Scholarship Program, Free Parking, Exclusive savings opportunities to in-store events, theme parks, movie tickets, local offerings, and much more!

RN Clinical Documentation Denials Auditor

Inova Health System's is looking for a RN Clinical Documentation Denials Auditor to join our team. This role is full-time, remote. 

Don't miss the opportunity to be a part of the organization and Hospital, recognized for excellence and innovation, and where we create an environment of respect and growth, where contributions are recognized and rewarded.

Responsibilities: 

• Demonstrates proficiency in reviewing and auditing medical records in Epic and/or 3M Encompass 360 concurrently or post-discharge.
• Completes work in line with standards for productivity and effectiveness as measured by success rates in overturning Diagnosis Related Group (DRG) challenges.
• Summarizes audit findings for individual records along with specific documentation guidelines to improve expected clinical outcomes for an individual physician, physician practice, or specialty.
• Conducts follow-up audits (i.e., with routine feedback until documentation practice comes into line with expected clinical outcomes.
• Demonstrates proficiency with Cobius to access external audit work, record summary results and upload appeal letters.
• Demonstrates proficiency with Encompass 360 to review electronic medical records with advanced functions (i.e. ex, auto-suggest and search) and record detail coding audit results.
• Showcases proficiency in reviewing records in Epic electronic health record 
• Demonstrates proficiency in writing effective appeal letters that include appropriate coding guidelines and medical references.
• Assists Coding Quality Manager and Coding Director in work related to second and third-level appeals as needed.
• Identifies trends in external audit findings related to coding quality and physician documentation. Prepares educational communications related to these findings.
• Accesses and processes work in Epic work queues and Cobius audit functions.
• Evaluates physicians' documentation, diagnostic reports, and clinical findings for validation of diagnoses.
• Processes the requests for second opinion reviews when clinical validity is not supported or in question.
• May perform additional duties as assigned.

Requirements:

• Hours: full-time, remote
• Education: Minimum Associate Degree in Nursing
• Experience: Minimum 7 years of recent experience in CDI, DRG validation or coding audit in an acute hospital setting with clinician training as RN, BSN, NP, PA or MD
• Certification: Certified Coding Specialist & Certified Clinical Documentation Specialist (ACDIS/AHIMA certification, CCDS or CDIP is required)
• Licensure: Current RN license and eligible to practice in VA. or MD

More about Inova Health System!

• Full Benefits Package
• Inova Awards and Recognition
• Inova YouTube Channel
• Inova Facebook Careers Page

#LI-VK1 

We are Inova, Northern Virginia's leading nonprofit healthcare provider. Every day, our 24,000+ team members provide world-class healthcare to the communities we serve. Our people are the reason we're a national leader in healthcare safety, quality and patient experience. And from best-in-class facilities to professional development opportunities, we support them at every step. At Inova, we're constantly striving to be ever better - to shape a more compassionate future for healthcare. 

Inova Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, pregnancy (including childbirth, pregnancy-related conditions and lactation), race, religion, sex, sexual orientation, veteran status, genetic information, or any other characteristics protected by law.