Internal Nurse Auditor, Full time - Days

UChicago Medicine; Illinois; Hybrid; USD 70,000 - 100,000; Full time

Job summary

UChicago Medicine is seeking an Internal Nurse Auditor for the Revenue Cycle Administration Department to review patient charges and ensure proper capture of services. You will contact departments and outside parties to gather documentation and defend documented services that are challenged by payors.

This role combines clinical knowledge with data analysis to improve accuracy and compliance. Responsibilities include performing analyses, generating management reports, advising on procedural

Qualifications

• B.S.N. degree required.
• RN license required.
• 1-2 years of auditing medical records/medical claims experience.
• Excellent communication and writing skills, ability to work effectively on multiple projects simultaneously, problem solving ability, and team player.
• Excellent mathematical skills, proficient in Microsoft Office applications, and applicable computer systems. Ability to serve as a resource for staff and/or temporary workers in the department.

Responsibilities

• Reviews patient charge statements and identifies services performed but not properly captured on the patient's bill as well as defends properly documented and delivered services which are being challenged by their party payors or their agents.
• Performs data analysis and verifies information to ensure records are accurate, and provides reports on findings to management.
• Provides recommendations for correcting unsatisfactory conditions, improving procedures, and reducing costs.
• Utilizes computer systems to evaluate data, and substantiates the validity of reported information.
• Researches and clarifies issues related to patient charge statement and contacts departments/third party payors to resolve issues.
• Assist management in establishing and implementing policies and procedures for internal controls to ensure compliance with regulations.
• Performs other duties and projects as assigned.

Skills

Communication skills

Data analysis

Attention to detail

Team player

Education

B.S.N. degree

Tools

Microsoft Office

Job description

Job Description

Be a part of a world-class academic healthcare system,

Internal Nurse Auditor for the Revenue Cycle Administration Department.

The Internal Nurse Auditor, under general direction, reviews patient charge statements and identifies services performed but not properly captured on the patient's bill as well as defends properly documented and delivered services which are being challenged by their party payors or their agents. In the position this person will contact departments and outside parties to gather documentation related to patient charges and services.

Job Description

Be a part of a world-class academic healthcare system, UChicago Medicine, as an Internal Nurse Auditor for the Revenue Cycle Administration Department. The Internal Nurse Auditor, under general direction, reviews patient charge statements and identifies services performed but not properly captured on the patient's bill as well as defends properly documented and delivered services which are being challenged by their party payors or their agents. In the position this person will contact departments and outside parties to gather documentation related to patient charges and services.

Essential Functions

• Reviews patient charge statements and identifies services performed but not properly captured on the patient's bill as well as defends properly documented and delivered services which are being challenged by their party payors or their agents.
• Performs data analysis and verifies information to ensure records are accurate, and provides reports on findings to management.
• Provides recommendations for correcting unsatisfactory conditions, improving procedures, and reducing costs.
• Utilizes computer systems to evaluate data, and substantiates the validity of reported information.
• Researches and clarifies issues related to patient charge statement and contacts departments/third party payors to resolve issues.
• Assist management in establishing and implementing policies and procedures for internal controls to ensure compliance with regulations.
• Performs other duties and projects as assigned.

Required Qualifications

• B.S.N. degree required
• RN license required.
• 1-2 years of auditing medical records/medical claims experience.
• Excellent communication and writing skills, ability to work effectively on multiple projects simultaneously, problem solving ability, and team player.
• Excellent mathematical skills, proficient in Microsoft Office applications, and applicable computer systems. Ability to serve as a resource for staff and/or temporary workers in the department.

License/Certifications

• RN license State of Illinois

Position Details

• Job Type/FTE: Full Time (1.0 FTE)
• Shift: Days, Monday-Friday
• Unit/Department: Revenue Cycle
• Work Location: Flexible Remote (Will need to commit to being onsite when needed)
• CBA Code: Non-union

About Us

We’ve been at the forefront of medicine since 1899. We provide superior healthcare with compassion, always mindful that each patient is a person, an individual. To accomplish this, we need employees with passion, talent and commitment… with patients and with each other. We’re in this together: working to advance medical innovation, serve the health needs of the community, and move our collective knowledge forward. If you’d like to add enriching human life to your profile, UChicago Medicine is for you. Here at the forefront, we’re doing work that really matters. Join us. Bring your passion.

UChicago Medicine is growing; discover how you can be a part of this pursuit of excellence at: UChicago Medicine Career Opportunities

UChicago Medicine is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status and other legally protected characteristics.

As a condition of employment, all employees are required to complete a pre-employment physical, background check, drug screening, and comply with the flu vaccination requirements prior to hire. Medical and religious exemptions will be considered for flu vaccination consistent with applicable law.

Compensation & Benefits Overview

UChicago Medicine is committed to transparency in compensation and benefits. The pay range provided reflects the anticipated wage or salary reasonably expected to be offered for the position.

The pay range is based on a full-time equivalent (1.0 FTE) and is reflective of current market data, reviewed on an annual basis. Compensation offered at the time of hire will vary based on candidate qualifications and experience and organizational considerations, such as internal equity. Pay ranges for employees subject to Collective Bargaining Agreements are negotiated by the medical center and their respective union.

Review the full complement of benefit options for eligible roles at Benefits - UChicago Medicine.