RN/Registered Nurse - Clinical Reviewer - Hopewell

SPECIFIC ELEMENTS ANDESSENTIAL FUNCTIONS 1 Performsclinicalevaluation of the medical record including physician documentation andclinical results including lab, diagnostic information and treatment plans 2 Facilitatesmodifications to clinical documentation through concurrent interactions withphysicians and other members of the health care team to support severity ofillness 3 Communicateswith appropriate members of the healthcare team to ensure accurate and completedocumentation is in the medical record 4 Demonstrates an understanding ofcomplications, co-morbidities, severity of illness, risk of ` mortality, case mix index, principaland secondary diagnoses, and MS-DRG's 5 Analyzesdata and information pertinent to how documentation reflects severity ofillness and reports findings to appropriate entities (i.e. medical staff,committees, etc) 6 Demonstrates proficiency in computerusage including database, spreadsheet, presentation, word processing programsand internet searches 7 IncorporatesCMS rules and regulations into daily practice and stays abreast of changes 8 Coordinates and provides education to allinternal customers related to compliance, coding and clinical documentation EXPERIENCE Required – RN with 5years acute care nursing experience or RHIA/RHIA with 10 years inpatient codingexperience Preferred– RN with 10 years acute care nursing experience, advanced clinical expertise EDUCATION Required– currently licensed as a RegisteredNurse, CCS