Nurse Auditor

Schedule

Full time

Shift

Day (United States of America)

Address

3100 E FLETCHER AVE

City

TAMPA

State

Florida

Postal Code

33613

Job Description

• Assists during audits involving hospital billing. Conducts research into the legitimacy of charges.
• Logs price and billing complaints. Other duties as assigned.
• Makes process improvement recommendations to audited nursing staff. Leads charge accuracy improvement meetings addressing specific process and charge issues.
• Monitors charge accuracy levels for all revenue-producing departments.
• Investigates charge issues from interface rejection reports, SSI edits, or coding software for possible correction.
• Reviews and corrects charge errors found during audits.
• Participates in meetings focused on process improvement initiatives related to charge accuracy.
• Communicates with appropriate staff or manager when charge errors require correction by the originating department.
• Performs other duties as assigned

Knowledge, Skills, and Abilities

• Ability to interact with the Hospital Financial Department, HIM personnel, and departmental leaders. [Required]
• Knowledge of the disease process and treatment methodology is required and utilized at least 50% of the time. [Required]
• Knowledge of ICD-10 and CPT Coding Principles as well as billing methodologies. Knowledge of computer system includes Windows, Excel, Epic EMR system. Ability to communicate effectively in writing and verbally. Must have financial analysis capabilities. [Required]
• Occasional contact with patients and outsiders. Regular contact with employees. [Required]
• The Nurse Auditor has access to institutional financial goals and ongoing reports supporting the achievement and benchmarks of the Finance Committee. The Nurse Auditor has the responsibility to adhere to the AdventHealth Corporate Compliance plan, to the rules and regulations of all local, state, and Federal agencies, and to the standards of all accrediting bodies. [Required]
• Must be adaptable and flexible as required. [Required]
• Regional Travel up to 20% may be required. [Required]
• Knowledge of the disease process and treatment methodology is required and utilized at least 50% of the time. [Required]

Education

• Associate of Nursing [Required]
• Bachelor's [Preferred]

Field of Study

• in Nursing, Business, Accounting, Finance, or another related field

Work Experience

• 3+ auditing experience either for hospitals or insurance companies or healthcare revenue cycle experience with a focus in one or more of the following areas: coding, charge integrity, charge reconciliation, charge compliance, charge auditing, cdm compliance, and hospital / professional billing. or relevant clinical hospital experience. [Preferred]
• 3+ clinical hospital experience in audit specialty hired to audit [Required]
• Case management, Utilization RN, Coding or equivalent. [Preferred]
• Epic experience [Preferred]

Additional Information

• N/A

Licenses and Certifications

• Registered Nurse (RN) [Required]

Pay Range

$68,132.50 - $119,520.35