Remote RN Revenue Integrity Auditor

Intermountain Healthcare Inc.; Jackson (MS); Remote; USD 56,000 - 85,000; Full time

Job summary

Intermountain Health is seeking a Revenue Integrity RN Charge/Coding Auditor to consult on clinical charge audits for Intermountain hospitals and clinics. You will audit medical records for denials review, defense audits, disallowed charges, and retrospective reviews, ensuring compliance with laws and coding guidelines.

The role requires RN licensure and AAPC/AHIMA coding certification, with remote work options and potential onsite interviews.

Qualifications

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

Responsibilities

• Apply evidence-based utilization review criteria to determine audit viability.
• Assess the appropriateness of clinical appeal requests against payer policies and regulations.
• Collaborate with multidisciplinary stakeholders during audits.
• Identify root causes for denials and communicate with the care team.
• Serve as a subject matter expert on hospital charging, documentation, and medical necessity decisions.
• Support clinical departments with policy guidance, training, and education.
• Maintain understanding of projects and use of technology and systems.
• Complete ongoing licensure CEUs as required.

Skills

Collaboration

Problem solving

Critical thinking

Detail-oriented

Clinical judgement

Effective communication

Patient advocacy

Computer literacy

Efficiency oriented

Results Focused

Education

Registered Nurse license

AAPC/AHIMA coding certification

Tools

Microsoft Office

EMR systems

Electronic databases

Job description

Intermountain Health is seeking a Revenue Integrity RN Charge/Coding Auditor to consult on clinical charge audits for Intermountain hospitals and clinics. You will audit medical records for denials review, defense audits, disallowed charges, and retrospective reviews, ensuring compliance with laws and coding guidelines.

The role requires RN licensure and AAPC/AHIMA coding certification, with remote work options and potential onsite interviews.