Registered Nurse-Charge Auditor

Job Description

Job Description:

The Registered Nurse – Charge Auditor plans, conducts, and performs charge audits, based on clinical documentation and billing practices for conformity with applicable regulatory requirements. Provides training and education to clinical/charging teams on appropriate documentation and charge capture processes. Identifies proactive opportunities to enhance charge capture processes, regulatory compliance and facilitates appropriate revenue capture. Coordinates and monitors charge capture projects and works closely with clinical leadership to implement best practices and ensure audit findings are addressed.

Education Qualifications:

Key Responsibilities:

Performs daily, weekly, and monthly reconciliation of technical and professional services rendered by the department providers against medical record to ensure charges posted/billed for accurate charge capture

Works with clinical departments and other impacted departments to ensure audit findings are addressed and assist in implementing best charging practices

Identifies, and analyzes billing errors and works with appropriate departments to ensure corrections are made in billing systems in a timely manner

Provides training to staff engaged in billing data entry and related charge capture/reconciliation activities to ensure procedures are properly documented and charges are dropped appropriately, accurately, and timely

Other duties as assigned to meet client expectations that would include root cause analysis, research of complex charging issues, implementation of corrective actions & provide subject matter expertise during system upgrades & implementations

Coordinates and reports audit outcome regarding charge errors, percentage of savings or losses, data processing errors, the performance of hospital charging system, and documentation

Provides feedback of the audit outcomes to the appropriate department to allow for process improvement

Educational Requirements:

Associate degree or bachelor’s degree in nursing

Required Qualifications:

2 years of professional nursing experience

AND

2 years of work experience in healthcare coding, billing, charge capture, reimbursement

Licensure/Certification Qualifications:

Certification/Licensure Requirements:

Current licensure by the applicable state board of nursing as an RN (Registered Nurse)

Job Location: Business Service Center

Shift Rotation: Day Rotation (United States of America)

Shift Start/End: vary/vary

Hours Per Pay Period: 80

Compensation Range: $33.21 – $49.82 / hour

Union:

FTE: 1

Weekends:

Call Obligations:

Sign On Bonus:

Equal Employment Opportunity (EEO) at Essentia

It is our policy to afford EEO to all individuals, regardless of race, religion, color, sex, pregnancy, gender identity, national origin, age, disability, family medical history, genetic information, sexual orientation, marital status, military service or veteran status, culture, socio-economic status, status with regard to public assistance, and other factors not related to qualifications, including employees or applicants who inquire about, discuss, or disclose their compensation or the compensation of other employees or applicants, or membership or activity in a local human rights commission, or any other category as defined by law.