RN Nurse Auditor- Remote

About the Role

This position performs proactive/prospective audits, retrospective/defense audits, and both targeted and ad hoc charge capture audits. Works in conjunction with clinical personnel during all audits, schedules, prepares action plans, and reports out during the Chart Audit Committee. Assists, advises, and provides expert consultation with clinical departments to ensure all charges and medical documentation are appropriate and complete for health information management (HIM) and billing purposes. Assists in special projects and conducts internal training to ensure competency and compliance in all aspects of the revenue cycle.

Responsibilities

• Performs defensive and charge capture auditing functions.
• Handles all aspects of the Chart Audit Committee.
• Communicates audit results with all applicable stakeholders.
• Resolves all assigned pre-bill and post-bill edit questions.
• Adapts behavior to the specific patient population, including but not limited to respect for privacy, method of introduction to the patient, adapting explanation of services or procedures to be performed, requesting permissions, and communication style.
• Performs other related duties as required.
• Remains knowledgeable on current federal, state, and local laws, accreditation standards, or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations, and standards.

Requirements

• Graduate of an accredited school of nursing.
• Current registered nurse (RN) license in state of practice.
• 5 years of related healthcare experience, OR 3 years of related healthcare experience with a master's degree.

Preferred Qualifications

• Master’s degree in finance, accounting, business/health administration, nursing, or related field.
• Related Professional Certification.

Skills

• Proficiency in using computers, software, and web-based applications.
• Effective verbal and written communication skills and ability to present information clearly and professionally to varying levels of individuals throughout the patient care process.
• Strong conflict resolution skills.
• Strong presentation skills.
• Ability to work a flexible work schedule (e.g., 24/7, weekend, holiday, on-call availability) and travel throughout and between facilities.

Physical and Environmental Demands

• Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects.
• Normal routine involves no exposure to blood, body fluid, or tissue, but exposure or potential for exposure may occur.
• The incumbent works with patients who have known or suspected communicable diseases and may enter isolation rooms.
• Occupational risk for exposure to all communicable diseases.
• Potential for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning, and/or disposal of contaminated waste.