Remote RN Charge & Coding Auditor

Intermountain Healthcare Inc.; Montpelier (VT); Remoto; USD 57.000 - 86.000; Tempo pieno

Descrizione del lavoro

Intermountain Health is seeking a Revenue Integrity RN Charge/Coding Auditor to perform clinical charge audits for denials review, defense audits, disallowed charges, and retrospective reviews. You will act as a clinical resource across Revenue Cycle, ensuring compliance with laws, rules, and coding guidelines while communicating denial activity to stakeholders and medical review boards.

This role supports remote work where approved.

Competenze

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

Mansioni

• Use evidence-based utilization review criteria to determine viability for audits.
• Assess 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 healthcare team.
• Serve as subject matter expert for hospital charging, documentation, clinical disease processes 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 and certifications.

Conoscenze

Collaboration

Problem solving

Critical thinking

Detail-oriented

Sound clinical judgement

Effective communication

Patient/hospital advocacy

Computer literacy

Efficiency oriented

Results Focused

Formazione

RN license

AAPC/AHIMA certification

Strumenti

Microsoft Office

EMR systems

Electronic databases

Descrizione del lavoro

Intermountain Health is seeking a Revenue Integrity RN Charge/Coding Auditor to perform clinical charge audits for denials review, defense audits, disallowed charges, and retrospective reviews. You will act as a clinical resource across Revenue Cycle, ensuring compliance with laws, rules, and coding guidelines while communicating denial activity to stakeholders and medical review boards.

This role supports remote work where approved.