ICU RN Auditor

Go-Get Data Consultancy; Taguig; On-site; PHP 1,200,000 - 1,800,000; Full time

Job summary

A healthcare consultancy firm in Taguig is seeking an experienced ICU RN Auditor to assess medical records, coding accuracy, and compliance in ICU settings. The ideal candidate will have 5+ years in auditing and a strong background in critical care nursing. Responsibilities include conducting audits, preparing reports, and collaborating with healthcare teams to ensure documentation accuracy.

Qualifications

• Minimum 5 years experience in Post Payment Claims Auditing.
• Understanding of ICD 9/10, CPT/HCPCS coding and DRG guidelines.
• Exposure to ICU bedside or hospital setting.
• Familiarity with CMS guidelines and medical insurance processing.

Responsibilities

• Conduct audits of ICU patient records for compliance.
• Prepare detailed audit reports with findings and recommendations.
• Collaborate with healthcare teams for documentation improvement.
• Collaborate with physicians and staff to provide feedback for documentation improvement.
• Ensure adherence to hospital policies and regulatory requirements.
• Prepare detailed audit reports with findings and trends.
• Assist in developing training programs to improve documentation accuracy.
• Stay updated on coding changes and best practices in medical auditing.

Skills

Detail-oriented

Critical Care Nursing

Medical Auditing

Regulatory Compliance

Education

Bachelor's degree in Nursing

Tools

ICD-10 Coding

CPT/HCPCS Coding

DRG Guidelines

Job description

Overview

Hybrid - Taguig | 5-10 Yrs Exp | Bachelor | Full-time

Job title: ICU RN Auditor

Work set-up: Hybrid in Taguig

Work shift: Mid-shift

Job Description

We are seeking a detail-oriented and experienced ICU RN Auditor to review and assess medical records, coding accuracy, and documentation compliance in intensive care unit (ICU) settings. The ideal candidate will have a strong background in critical care nursing, medical auditing, and regulatory compliance to ensure adherence to healthcare standards and best practices.

Responsibilities

• Conduct audits of ICU patient records to assess accuracy, completeness, and compliance with medical guidelines and policies.
• Evaluate documentation for proper coding, billing, and reimbursement alignment with healthcare regulations.
• Identify discrepancies, errors, and areas for improvement in ICU charting and clinical documentation.
• Collaborate with healthcare teams, physicians, and administrative staff to provide feedback and recommendations for documentation improvement.
• Ensure adherence to hospital policies, CMS guidelines, and other regulatory requirements.
• Prepare detailed audit reports, including findings, trends, and recommendations.
• Assist in developing training programs for ICU nurses and medical staff to improve documentation accuracy.
• Stay up to date with healthcare regulations, coding changes (ICD-10, CPT), and best practices in medical auditing.

Qualifications

• Minimum 5 years experience in Post Payment Claims Auditing or ICU RN Auditor and 5-10 years experience on ICU/CCU nursing experience
• Exposed to ICU experience such as local/international bedside/hospital setting
• Has the following experience in ICU: reading patient’s record, auditing, assessment, claims, appeals, denials
• Has the understanding of ICD 9/10, CPT/HCPCS coding, DRG guidelines, correct coding initiative, revenue codes, modifiers and APC reimbursement
• PHRN English Language Medical Insurance Processing Strong Work Ethic Outbound Call

Location & Advisory

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HR Manager Go-Get Data Consultancy

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