Revenue Integrity Nurse Auditor
September 14, 2018
Atlantic Health is seeking a full time RN Billing Compliance in Revenue Integrity.
Responsibilities Essential Functions:
- Ensure that services are ordered by a physician consistent with industry standards and provided to the patient according to hospital policies/protocol, documented in the medical record, and charged correctly.
- Audit medical records and billing documents for appropriate documentation of (ICD-10 CM, CPT and HCPCS) coding and billing charges.
- Enter departmental charges and/or credits as appropriate based on audit findings.
- Prepare weekly and monthly summary reports of audit findings.
- Provide educational programs to physicians and clinical departments to help reduce lost revenue and improve documentation.
- Participate and develop internal controls to target revenue recovery throughout the organization by identifying charge capture, coding, and reimbursement problems and implementing solutions.
- Perform departmental audits to ensure billing procedures follow the Organization’s and regulatory guidelines. Report results back to department managers and work with department to correct the process and implement solutions.
- Must have ability to reason and communicate both written and verbal.
- E xcellent problem solving skills.
- Registered Nurse (BSN preferred)
- Minimum of 5 years clinical experience
- Auditing experience preferably with a healthcare organization or insurance company
- Case Manager and/or coding experience a plus
- Working knowledge of medical terminology, patient care services and medical record chart documentation