Remote Revenue Integrity RN Auditor

Intermountain Healthcare Inc.; San Juan (PR); Remote; USD 57,000 - 86,000; Full time

Benefits offered by this job

Benefits package

Job summary

Intermountain Health seeks a Revenue Integrity RN Charge/Coding Auditor to audit clinical charges, review denials, and support revenue cycle departments. The role requires RN licensure and coding certification, with strong knowledge of charging, coding, and medical necessity decisions.

Remote work options are available with potential onsite interviews. The position emphasizes collaboration, detailed analysis, and adherence to regulatory guidelines, ensuring accurate hospital charging practices

Qualifications

• Current licensure as a registered nurse.
• Current coding certification through AAPC or AHIMA.
• Experience in Microsoft Office, EMR systems and electronic databases.
• Demonstrates in-depth knowledge of the healthcare claim denial process.
• Demonstrates clear understanding of the healthcare revenue cycle.

Responsibilities

• Use evidence-based utilization review criteria to determine viability for audits.
• Assess the appropriateness of clinical appeal requests by payer policies and regulations.
• Collaborate with multidisciplinary stakeholders during the audit process.
• Identify and communicate root causes for denials with the healthcare team.
• Serve as a subject matter expert for hospital charging, documentation, and medical necessity decisions.
• Develop and maintain understanding of projects and assigned functions including technology and systems.
• Complete ongoing education and CEU requirements to maintain licensure.

Skills

Collaboration

Problem solving

Critical thinking

Detail-oriented

Sound clinical judgement

Effective communication

Patient/hospital advocacy

Computer literacy

Efficiency oriented

Results Focused

Education

Registered nurse license

Coding certification (AAPC/AHIMA)

Tools

Microsoft Office

EMR systems

Electronic databases

Job description

Intermountain Health seeks a Revenue Integrity RN Charge/Coding Auditor to audit clinical charges, review denials, and support revenue cycle departments. The role requires RN licensure and coding certification, with strong knowledge of charging, coding, and medical necessity decisions.

Remote work options are available with potential onsite interviews. The position emphasizes collaboration, detailed analysis, and adherence to regulatory guidelines, ensuring accurate hospital charging practices