Remote Revenue Integrity RN Auditor (Charge/Coding)

Intermountain Healthcare Inc.; Augusta (ME); Remote; USD 57,000 - 86,000; Full time

Job summary

Intermountain Health is seeking a Revenue Integrity RN Charge/Coding Auditor for remote engagement in the United States. The role conducts clinical charge audits for denial reviews, retrospective reviews, and communicates denial activity to stakeholders up to medical review boards and courts.

Requires active RN licensure and coding certification (AAPC/AHIMA). Minimum knowledge of healthcare claims denial processes and revenue cycle; EPIC experience preferred.

Qualifications

• Current licensure as a registered nurse.
• Current coding certification through AAPC or AHIMA.
• Experience in Microsoft Office, electronic medical records 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 criteria to determine viability for audits using supporting documentation.
• 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.

Skills

Collaboration

Problem solving

Critical thinking

Detail-oriented

Communication

Patient advocacy

Computer literacy

Efficiency

Results Focused

Education

Registered Nurse licensure

AAPC/AHIMA coding certification

Tools

Microsoft Office

Electronic Medical Records

Electronic databases

Job description

Intermountain Health is seeking a Revenue Integrity RN Charge/Coding Auditor for remote engagement in the United States. The role conducts clinical charge audits for denial reviews, retrospective reviews, and communicates denial activity to stakeholders up to medical review boards and courts.

Requires active RN licensure and coding certification (AAPC/AHIMA). Minimum knowledge of healthcare claims denial processes and revenue cycle; EPIC experience preferred.