HCA, Hospital Corporation of America RN/Registered Nurse - Clinical Reviewer in Hopewell, Virginia


1 Performs clinical evaluation of the medical record including physician documentation and clinical results including lab, diagnostic information and treatment plans

2 Facilitates modifications to clinical documentation through concurrent interactions with physicians and other members of the health care team to support severity of illness

3 Communicates with appropriate members of the healthcare team to ensure accurate and complete documentation is in the medical record

4 Demonstrates an understanding of complications, co-morbidities, severity of illness, risk of ` mortality, case mix index, principal and secondary diagnoses, and MS-DRG’s

5 Analyzes data and information pertinent to how documentation reflects severity of illness and reports findings to appropriate entities (i.e. medical staff, committees, etc)

6 Demonstrates proficiency in computer usage including database, spreadsheet, presentation, word processing programs and internet searches

7 Incorporates CMS rules and regulations into daily practice and stays abreast of changes

8 Coordinates and provides education to all internal customers related to compliance, coding and clinical documentation

EXPERIENCE Required – RN with 5 years acute care nursing experience or RHIA/RHIA with 10 years inpatient coding experience Preferred – RN with 10 years acute care nursing experience, advanced clinical expertise

EDUCATION Required – currently licensed as a Registered Nurse, CCS

Job: *Case Management

Title: RN/Registered Nurse - Clinical Reviewer

Location: Virginia-Hopewell-John Randolph Medical Center - Hopewell

Requisition ID: 02699-41149