Clinical Documentation Review Manager (RN)
The New York Eye and Ear Infirmary (NYEE), one of the Best Hospitals in America as ranked by USNews & World Report, has an opportunity available for a Full Time Clinical Documentation Review Manager (RN) who will collaborate with our Admitting, Quality, and Finance Teams to ensure appropriate clinical information is available in order for NYEE to receive appropriate reimbursement for services provided.
Reporting to our Director of Admitting and Director of Quality, the Clinical Documentation Review Manager will be responsible for:
Reviewing all pre-admission clinical documentation for inpatient and ambulatory surgery cases to ensure that documentation complies with all NYEE rules and regulations; communicating to physician offices in the case of documentation deficiency; tracking and monitoring these deficiencies for appropriate internal reporting
Reviewing census for patients in house over 48 hours to insure appropriate authorizations for continued admission coverage
Administering Medicare Advanced Beneficiary Notification (ABN) as needed for patients registered in NYEE Admitting Office
Collaborating with the Medical Records department to develop a clinical documentation review process and documentation improvement initiative that enhances NYEE clinical documentation; performing monthly audits on all inpatient cases and samples of ambulatory surgery and clinic cases, developing a reporting tool to utilize for appropriate internal communication
Reviewing surgical cases utilizing implants, high cost drugs, or other specialty items to ensure appropriate reimbursement for NYEE
New York State Registered Professional Nurse
Bachelors Degree in health related field preferred
A minimum of three years experience in clinical documentation review/utilization management (UM)
A minimum of two years experience in a supervisory role
Strong organizational skills with the ability to multi-task and function independently
Proficiency with Microsoft Office programs
Excellent interpersonal, communication, and written skills
Ability to work under pressure, meet deadlines, and flexibility
Knowledge of State and Federal Regulatory Standards for acute and ambulatory care facilities
Knowledge of The Joint Commission and Centers for Medicare/Medicaid Services (CMS) rules and regulations
The New York Eye and Ear Infirmary was established in 1820 to meet the eye care needs of New Yorkers. In keeping with its heritage, todays Infirmary, a member of Continuum Health Partners, Inc., is a voluntary, not-for-profit specialty hospital providing comprehensive outpatient and state-of-the-art medical/surgical care in the disciplines of Ophthalmology, Otolaryngology/ Head & Neck Surgery, and Plastic & Reconstructive Surgery.
To apply, please e-mail your resume including salary requirements, to: email@example.com (Attn: Clinical Manager). The New York Eye and Ear Infirmary is an Equal Opportunity Employer.